Individual provider Active NPI

Tracy Sinha Khona, MD

  • Allergy & Immunology Physician
  • Jacksonville, FL
National Provider Identifier
1356367650
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
ME26358 Issued in FL
Practice address
4131 University Blvd S Ste 4a
Jacksonville, FL 32216-4322
Phone
(904) 733-6487
Fax
(904) 733-6542
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X ME26358 FL
Allergy & Immunology Physician 207K00000X ME26358 FL Primary

Addresses

Primary practice location

4131 University Blvd S Ste 4a
Jacksonville, FL 32216-4322

Mailing address

4131 University Blvd S Ste 4a
Jacksonville, FL 32216-4322
Phone (904) 733-6487

Other identifiers 1

IdentifierTypeStateIssuer
259244400MedicaidFL

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
I20090121000344 FL Practitioner - Allergy/Immunology 5193889095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4131 University Blvd S
Suite 4a
Jacksonville, FL 32216-4322
Phone (904) 733-6487

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26358FLMDDentist
ME26358FLMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
T & R Inc CurrentSince Oct 1, 2013 Accepting new patients

Locations

96279 Brady Point Rd
Fernandina Beach, FL 32034
Phone (904) 321-0088

3617 Crown Point Rd
Ste 6
Jacksonville, FL 32257
Phone (904) 288-9127

4131 University Blvd S
Jacksonville, FL 32216
Phone (904) 733-3992

4131 University Blvd S
Ste 4A
Jacksonville, FL 32216
Phone (904) 733-6487

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1356367650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 UNIVERSITY BLVD S STE 4A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164322",
            "telephone_number": "904-733-6487",
            "fax_number": "904-733-6542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 UNIVERSITY BLVD S STE 4A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164322",
            "telephone_number": "904-733-6487",
            "fax_number": "904-733-6542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINHA KHONA",
        "first_name": "TRACY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "FL",
            "license": "ME26358",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME26358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259244400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.