Hiten Vithal Kisnad, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME0066482 Issued in FL

Practice address

3840 Belfort Rd Ste 306
Jacksonville, FL 32216-8210

Phone

(904) 854-9177

Fax

(904) 854-6696

NPI assigned

May 10, 2006

Last updated

Mar 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 25, 2017 through Sep 25, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Hiten Kisnad MD PA

  dba Beaches Psychiatry

  • Psychiatry Physician
  • Jacksonville Beach, FL
  • NPI 1477500817
  NPD (past) Authorized official
• Avanti Wellness Center Flllp

  • Community/Behavioral Health Agency
  • St Augustine, FL
  • NPI 1215179056
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1235189457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 BELFORT RD STE 306",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168210",
            "telephone_number": "904-854-9177",
            "fax_number": "904-854-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 BELFORT RD STE 306",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168210",
            "telephone_number": "904-854-9177",
            "fax_number": "904-854-6696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3840 Belfort Rd Ste 306",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322168210",
            "country_code": "US",
            "telephone_number": "904-854-9177",
            "fax_number": "904-854-6696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISNAD",
        "first_name": "HITEN",
        "middle_name": "VITHAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME66482",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME0066482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377054100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Kirvin, PHARMD
• Stacy Rae Kiseljack, ARNP
• Ashley Vickery Kiser, M.S., BCBA
• Ruby Kish, RN, LCSW
• Rami Kishek
• Madison Nicole Kissel, DNP-FNP
• Jonathan Kistemaker, AA
• Gail Kitani
• Garry S Kitay, M.D.
• Levi K Kitchen, M.D.

• Psychiatry Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.