Individual provider Active NPI

Kapil Pokharel, MD

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1164050357
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME161195 Issued in FL
Practice address
3059 Edgewood Ave W
Jacksonville, FL 32209-2207
Phone
(904) 647-3180
Fax
(904) 425-9030
NPI assigned
Apr 1, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME161195 FL Primary

Addresses

Primary practice location

3059 Edgewood Ave W
Jacksonville, FL 32209-2207

Mailing address

3059 Edgewood Ave W
Jacksonville, FL 32209-2207
Phone (904) 647-3180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230614003719 FL Practitioner - Family Practice 7214395797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dedicated Senior Medical Center of Florida, LLCGroup PAC ID 4486932100, 56 clinicians

Practice addresses (Care Compare)

3059 Edgewood Ave W
Jacksonville, FL 32209-2207
Phone (904) 647-3180

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jul 1, 2023 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

3059 Edgewood Ave W
Jacksonville, FL 32209
Phone (904) 647-3180

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1164050357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3059 EDGEWOOD AVE W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322092207",
            "telephone_number": "904-647-3180",
            "fax_number": "904-425-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3059 EDGEWOOD AVE W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322092207",
            "telephone_number": "904-647-3180",
            "fax_number": "904-425-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POKHAREL",
        "first_name": "KAPIL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME161195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.