Individual provider Active NPI

Praveen Cheripalli, M.D

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1336336783
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME104859 Issued in FL
Practice address
1200 Riverplace Blvd
Suite 620
Jacksonville, FL 32207-9046
Phone
(904) 396-6620
Fax
(904) 396-6528
NPI assigned
Oct 1, 2007
Last updated
Oct 29, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 725050925 IL
Internal Medicine Physician 207R00000X ME104859 FL Primary

Addresses

Primary practice location

1200 Riverplace Blvd
Suite 620
Jacksonville, FL 32207-9046

Mailing address

1200 Riverplace Blvd
Suite 620
Jacksonville, FL 32207-9046
Phone (904) 396-6620

Other identifiers 2

IdentifierTypeStateIssuer
146J0OtherFLBC/BS
001941200MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091027000230 FL Practitioner - Internal Medicine 4789721614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Physician Services of Florida PAGroup PAC ID 7012201965, 212 clinicians

Practice addresses (Care Compare)

200 Ave F NE
Winter Haven, FL 33881-4131
Phone (863) 293-1121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME104859FLMDInternal Medicine Physician
725050925ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
Hospital Physician Services of Florida PA Internal Medicine CurrentSince Apr 1, 2019 Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652

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

Hospital & facility affiliations 1

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": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1336336783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 RIVERPLACE BLVD",
            "address_2": "SUITE 620",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079046",
            "telephone_number": "904-396-6620",
            "fax_number": "904-396-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 RIVERPLACE BLVD",
            "address_2": "SUITE 620",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079046",
            "telephone_number": "904-396-6620",
            "fax_number": "904-396-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERIPALLI",
        "first_name": "PRAVEEN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-01",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "725050925",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME104859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "146J0",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001941200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.