Kanaklakshmi Masodkar, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME164601 Issued in FL

Practice address

30 Ardisia LN
Saint Johns, FL 32259-3881

Phone

(904) 376-3800

Fax

(904) 390-7458

NPI assigned

Jun 5, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Psychiatry

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Baptist Behavioral Health LLCGroup PAC ID 7315166394, 120 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmasodkar173261@baptisthealthsystemjacksonville.direct-ci.com

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.

• Baptist Behavioral Health, LLC

  • Professional Counselor
  • Jacksonville, FL
  • NPI 1215906649

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Southern Baptist Hospital of Florida Inc

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1841351632
  NPD (past)

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1164860748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748519",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748519",
            "telephone_number": "904-376-3800",
            "fax_number": "904-376-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ARDISIA LN",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322593881",
            "telephone_number": "904-376-3800",
            "fax_number": "904-390-7458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASODKAR",
        "first_name": "KANAKLAKSHMI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-05",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME164601",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "40562",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Austin Mang, DMD
• Tara Krista Marchand, OT
• Lauren J Marchefka, FNP
• Larissa Marie Marchetti, PHARMD
• Mary S Marshall
• Michele Mason
• Stephany Matallana, PA
• Mary Stephens Mathis, PA-C
• Jennifer Sue Matthews, PA-C
• Maxwell Behavioral Health

• Psychiatry Physician in Saint Johns, FL
• Providers in Saint Johns, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.