Individual provider Active NPI

Khushboo Nilesh Parikh, MD

  • Pediatric Cardiology Physician
  • Jacksonville, FL
National Provider Identifier
1154618619
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
ME158753 Issued in FL
Practice address
841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350
Phone
(904) 202-8550
Fax
(904) 393-7808
NPI assigned
Jul 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 303946 LA
Pediatrics Physician 208000000X ME158753 FL
Pediatric Cardiology Physician 2080P0202X 303946 LA
Pediatric Critical Care Medicine Physician 2080P0203X 303946 LA
Pediatric Cardiology Physician 2080P0202X ME158753 FL Primary

Addresses

Primary practice location

841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350

Mailing address

PO Box 746645
Atlanta, GA 30374-6645
Phone (904) 202-2092

Other practice location 1

3650 NW DeVane St
Lake City, FL 32055-8730
Phone (904) 202-8550

Other practice location 2

601 N Clyde Morris Blvd Ste A
Daytona Beach, FL 32114-2300
Phone (904) 202-8550

Other practice location 3

2418 E Plaza Dr
Tallahassee, FL 32308-5301
Phone (850) 629-4861

Other practice location 4

8705 Perimeter Park Blvd Ste 8
Jacksonville, FL 32216-6353
Phone (904) 296-7771

Other practice location 5

1747 Baptist Clay Dr Ste 100
Fleming Island, FL 32003-8503
Phone (904) 202-8550

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kparikh82911@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170727000405 LA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 6901039957 Reassigns benefits to 4 organizations
I20230221000060 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 6901039957 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Cardiology of Louisiana, LLC Pediatric Cardiology CurrentSince Aug 1, 2022 Accepting new patients
Baptist Specialty Physicians Inc Pediatric Cardiology CurrentSince Feb 12, 2023 Accepting new patients
Pediatric Intensivists of la, LLC CurrentSince Jul 1, 2017 Accepting new patients
Wash-St Tammany Reg Medical Center Current Accepting new patients
Pediatric Hospitalists of Louisiana, LLC Pediatrics CurrentSince Jul 1, 2017 Accepting new patients
Baptist Specialty Physicians Inc Pediatric Cardiology CurrentSince Apr 1, 2023 Accepting new patients
The Nemours Foundation Past Accepting new patients

Locations

601 N Clyde Morris Blvd
Ste A
Daytona Beach, FL 32114
Phone (386) 252-3985

1747 Baptist Clay Dr
Ste 100
Fleming Island, FL 32003
Phone (904) 202-8550

8705 Perimeter Park Blvd
Ste 8
Jacksonville, FL 32216
Phone (904) 296-7771

841 Prudential Dr
Ste 280
Jacksonville, FL 32207
Phone (904) 202-8290

3650 NW Devane St
Lake City, FL 32055
Phone (386) 755-1221

2418 E Plaza Dr
Tallahassee, FL 32308
Phone (850) 629-4861

7777 Hennessy Blvd
Ste 103
Baton Rouge, LA 70808
Phone (225) 215-2255

8200 Constantin Blvd
Ste 200
Baton Rouge, LA 70809
Phone (225) 709-8633

433 Plaza St
Bogalusa, LA 70427
Phone (985) 730-6700

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1154618619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746645",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746645",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR STE 280",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078350",
            "telephone_number": "904-202-8550",
            "fax_number": "904-393-7808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3650 NW DeVane St",
            "address_purpose": "LOCATION",
            "city": "Lake City",
            "state": "FL",
            "postal_code": "320558730",
            "country_code": "US",
            "telephone_number": "904-202-8550",
            "fax_number": "904-393-7808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 N Clyde Morris Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321142300",
            "country_code": "US",
            "telephone_number": "904-202-8550",
            "fax_number": "904-393-7808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2418 E Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323085301",
            "country_code": "US",
            "telephone_number": "850-629-4861",
            "fax_number": "850-629-4859",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8705 Perimeter Park Blvd Ste 8",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322166353",
            "country_code": "US",
            "telephone_number": "904-296-7771",
            "fax_number": "904-296-7772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1747 Baptist Clay Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "320038503",
            "country_code": "US",
            "telephone_number": "904-202-8550",
            "fax_number": "904-393-7808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARIKH",
        "first_name": "KHUSHBOO",
        "middle_name": "NILESH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "303946",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME158753",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "LA",
            "license": "303946",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "LA",
            "license": "303946",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME158753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kparikh82911@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kparikh82911@direct.casso.us.com",
            "address_1": "433 Plaza St",
            "city": "Bogalusa",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704273729",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "433 Plaza St",
            "city": "Bogalusa",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704273729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.