Individual provider Active NPI

Suhas Vishnu Joshi, M.D.

  • Psychiatry Physician
  • Orange Park, FL
National Provider Identifier
1194747485
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME73086 Issued in FL
Practice address
1543 Kingsley Ave Ste 14
Orange Park, FL 32073-4570
Phone
(904) 264-6977
Fax
(904) 269-0870
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME73086 FL Primary

Addresses

Primary practice location

1543 Kingsley Ave Ste 14
Orange Park, FL 32073-4570

Mailing address

1543 Kingsley Ave Ste 14
Orange Park, FL 32073-4570
Phone (904) 264-6977

Other identifiers 3

IdentifierTypeStateIssuer
ME73086OtherFLSTATE LICENSE
100120400MedicaidFL
41996UOtherFLMEDICARE

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
I20051028000304 FL Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 3971520917 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
First Coast Psychiatric Services, P.a.Group PAC ID 9133441421, 7 clinicians
TBJ Behavioral Center LLCGroup PAC ID 4981789823, 15 clinicians

Practice addresses (Care Compare)

1543 Kingsley Ave
Suite 14
Orange Park, FL 32073-4570
Phone (904) 264-6977

6300 Beach Blvd
Jacksonville, FL 32216-2708
Phone (904) 724-9202

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME73086FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Coast Psychiatric Services, P.a. Psychiatry CurrentSince Sep 1, 2017 Accepting new patients
TBJ Behavioral Center LLC Psychiatry CurrentSince Oct 1, 2022 Accepting new patients
Mental Health Center of Jacksonville, Inc. Past Accepting new patients
Memorial Family Practice Associates, LLC Past Accepting new patients

Locations

6300 Beach Blvd
Jacksonville, FL 32216
Phone (904) 724-9202

1543 Kingsley Ave
Ste 14
Orange Park, FL 32073
Phone (904) 264-6977

Organizations & group practices 4

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1194747485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 KINGSLEY AVE STE 14",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734570",
            "telephone_number": "904-264-6977",
            "fax_number": "904-269-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 KINGSLEY AVE STE 14",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734570",
            "telephone_number": "904-264-6977",
            "fax_number": "904-269-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSHI",
        "first_name": "SUHAS",
        "middle_name": "VISHNU",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2023-03-07",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME73086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME73086",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100120400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "41996U",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.