Kunal Thakkar, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

ME104096 Issued in FL

Practice address

1560 Roberts Dr
Jacksonville Beach, FL 32250-3222

Phone

(904) 339-0350

NPI assigned

Jul 2, 2008

Last updated

Dec 6, 2018By 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 1

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

Otolaryngology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• Ascension St Vincent's Southside Hospital, Jacksonville, FL, CCN 100307
• Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GGJCBA/Endpoint/GGJCBA

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.

• Advanced Ear, Nose, Throat Associates, LLC

  • Otolaryngology Physician
  • Jacksonville Beach, FL
  • NPI 1861791402
  Medicare reassignment NPD Authorized official

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

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Genesis Rehabilitation Hospital, Inc.

  dba Brooks Rehabilitation Hospital Bartram Campus

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1376114413

  Inpatient rehabilitation facility

  Care Compare affiliation
• Genesis Rehabilitation Hospital, Inc.

  dba Brooks Rehabilitation

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1912947748

  Inpatient rehabilitation facility

  Care Compare affiliation
• St Lukes - St Vincents Healthcare

  dba Ascension St. Vincent's Southside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747
  Care Compare affiliation

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1306009139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 ROBERTS DR",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503222",
            "telephone_number": "904-339-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 ROBERTS DR",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503222",
            "telephone_number": "904-339-0350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4205 Belfort Rd Ste 2005",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322165876",
            "country_code": "US",
            "telephone_number": "904-339-0350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAKKAR",
        "first_name": "KUNAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME104096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryori Yuldana Tello, RD, LDN, CDM, CFPP
• Tender Chiropractic Health Center PA
• John G. Tender, D.C.
• Sandra J Terrazzano, ARNP, LMT
• Ryan James Terry, LMHC
• Karen K Thalinger, MD
• The Cove at Marsh Landing
• The Finishing Touch 904 LLC
• The Natural Hormone Institute Inc (Women's Medicine)
• Theralogy, LLC

• Otolaryngology Physician in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Otolaryngology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.