NPIMap

Individual provider Active NPI

Bachar Alkhalil, MD

  • Nephrology Physician
  • Orange Park, FL
National Provider Identifier
1316969595
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME100758 Issued in FL
Practice address
1563 Kingsley Avenue
Suite 106
Orange Park, FL 32073
Phone
(904) 389-5333
Fax
(904) 389-5332
NPI assigned
Jul 24, 2006
Last updated
Oct 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME100758 FL
Nephrology Physician 207RN0300X ME100758 FL Primary

Addresses

Primary practice location

1563 Kingsley Avenue
Suite 106
Orange Park, FL 32073

Mailing address

2 Shircliff Way
Suite 700 Depaul BLDG
Jacksonville, FL 32204
Phone (904) 389-5333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080620000534 FL Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Hospitalist 1456377001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Hospitalist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James D Baker III MD PAGroup PAC ID 9032011663, 19 clinicians

Practice addresses (Care Compare)

2 Shircliff Way 700 Depaul BLDG
Nephrology Associates of Northeast
Jacksonville, FL 32204-4759
Phone (904) 389-5333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME100758FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
James D. Baker III, M.D., PA Nephrology CurrentSince Mar 1, 2020 Accepting new patients
Florida Infectious Disease Associates PA PastSince Oct 11, 2020 Accepting new patients
Watson Clinic LLP Past Accepting new patients
Inpatient Consultants of Georgia, Inc Hospitalist Past Accepting new patients

Locations

13241 Bartram Park Blvd
Unit 1509
Jacksonville, FL 32258
Phone (904) 680-0055

2 Shircliff Way
Ste 415
Jacksonville, FL 32204
Phone (904) 389-5333

2 Shircliff Way
Ste 700
Jacksonville, FL 32204
Phone (904) 387-3001

1563 Kingsley Ave
Ste 106
Orange Park, FL 32073
Phone (904) 272-6161

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

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": "1601942400000",
    "number": "1316969595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY",
            "address_2": "SUITE 700 DEPAUL BLDG",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32204",
            "telephone_number": "904-389-5333",
            "fax_number": "904-389-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1563 KINGSLEY AVENUE",
            "address_2": "SUITE 106",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32073",
            "telephone_number": "904-389-5333",
            "fax_number": "904-389-5332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALKHALIL",
        "first_name": "BACHAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME100758",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME100758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.