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
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

Other identifiers 1

IdentifierTypeStateIssuer
281309200MedicaidFL

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

  • ARA South Jacksonville Dialysis Center Dialysis facility, Jacksonville, FL, CCN 682731
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • HCA Florida Orange Park Hospital Hospital, Orange Park, FL, CCN 100226
  • Ascension St Vincent'S St Johns County Hospital, St. Johns, FL, CCN 100361
  • Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
  • Ascension St Vincent'S Clay County Hospital, Middleburg, FL, CCN 100321
  • Encompass Health Rehabilitation Hospital of Jackso Inpatient rehabilitation facility, Jacksonville, FL, CCN 103052

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

Practice roles (4 of 6)

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

Locations

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

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

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

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

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare 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 and National Provider Directory roles.

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281309200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.