Raxitkumar Jinjuvadia, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME151069 Issued in FL

Practice address

3635 Clyde Morris Blvd Ste 100
Port Orange, FL 32129-2349

Phone

(386) 788-1242

Fax

(386) 756-8802

NPI assigned

Jun 18, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI, 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

Specialty

Gastroenterology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Borland Groover Clinic, PAGroup PAC ID 6507761301, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
• Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: raxitkumar.jinjuvadia.p1@direct.bgclinic.nextgenshare.com
• Direct secure messaging: rjinjuvadia194843@direct.hfhs.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Borland Groover Clinic, PA

  • Gastroenterology Physician
  • Jacksonville, FL
  • NPI 1881644912
  Medicare reassignment Care Compare group NPD
• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Medicare reassignment NPD
• Henry Ford Health System

  • Gastroenterology Physician
  • Detroit, MI
  • NPI 1205909892
  NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation
• Southeast Volusia Healthcare Corporation

  dba AdventHealth New Smyrna Beach

  • General Acute Care Hospital
  • New Smyrna Beach, FL
  • NPI 1871977942
  Care Compare affiliation

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1245467067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 CLYDE MORRIS BLVD STE 100",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321292349",
            "telephone_number": "386-788-1242",
            "fax_number": "386-756-8802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Clyde Morris Blvd Ste 270",
            "address_purpose": "LOCATION",
            "city": "Ormond Beach",
            "state": "FL",
            "postal_code": "321748182",
            "country_code": "US",
            "telephone_number": "386-788-7848",
            "fax_number": "386-756-8802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JINJUVADIA",
        "first_name": "RAXITKUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301093965",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301093965",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME151069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111664400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elise Jernigan
• Jessica Jordan OD LLC
• Jessica Jordan OD LLC (Dr. Jessica's Eyes That Smile Optometry)
• Dana Jickell, AUD
• Yolanda Renay Jiles
• Joanne D Saxour MD (Halifax Family Medicine)
• John D Lockenour D C Inc
• Devon James Johnson-Robinson
• Michelle Johnson
• Rachel Johnson

• Gastroenterology Physician in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.