Active NPI
Rafaela Gjondrekaj, CAA
- Anesthesiologist Assistant
- Jacksonville, FL
National Provider Identifier
1265157291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- AA779
- Practice address
- 807 Childrens Way
Jacksonville, FL 32207-8426 - Phone
- (904) 697-3600
- NPI assigned
- Oct 12, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | 75000161A | IN | |
| Anesthesiologist Assistant | 367H00000X | AA779 | FL | Primary |
Addresses
Primary practice location
807 Childrens Way
Jacksonville, FL 32207-8426
Mailing address
807 Childrens Way
Jacksonville, FL 32207-8426
Phone (904) 333-2142
Other practice location 1
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (317) 274-0275
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rgjondrekaj@direct.iuhealth.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Associate of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75000161A | IN | MD | Anesthesiologist Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Florida Jacksonville Physicians, Inc. | Anesthesiology | Current | Accepting new patients |
| University of Florida Jacksonville Physicians, Inc. | Current | Accepting new patients | |
| University of Florida Jacksonville Physicians Inc | Anesthesiology | Current | Accepting new patients |
Locations
655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680
1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1144276452
Anesthesiology
-
- Anesthesiology Physician
- Jacksonville, FL
- NPI 1699935965
-
- Physiological Laboratory
- Jacksonville, FL
- NPI 1831800952
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708905600000",
"number": "1265157291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 CHILDRENS WAY",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078426",
"telephone_number": "904-333-2142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 CHILDRENS WAY",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078426",
"telephone_number": "904-697-3600"
}
],
"practiceLocations": [
{
"address_1": "1701 N Senate Blvd",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462021239",
"country_code": "US",
"telephone_number": "317-274-0275",
"fax_number": "317-274-0256",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GJONDREKAJ",
"first_name": "RAFAELA",
"credential": "CAA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-12",
"last_updated": "2024-02-26",
"certification_date": "2024-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "IN",
"license": "75000161A",
"primary": false
},
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "FL",
"license": "AA779",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rgjondrekaj@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1701 N Senate Blvd",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462021239",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.