Koteswari Kancha, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

98954 Issued in FL

Practice address

13241 Bartram Park Blvd Unit 409
Jacksonville, FL 32258-5237

Phone

(904) 400-6800

Fax

(904) 400-6801

NPI assigned

Oct 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

NephrologyAlso: Internal Medicine

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

National Kidney Partners LLPGroup PAC ID 7012981350, 63 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Jacksonville South Dialysis Center Dialysis facility, Jacksonville, FL, CCN 102873
• DaVita Memorial Plaza Dialysis Dialysis facility, Jacksonville, FL, CCN 682516
• DaVita Clay County Dialysis Dialysis facility, Middleburg, FL, CCN 682572
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkancha78955@direct.acumenmd.com

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.

• Jacksonville Kidney Center LLC

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1255647491
  Medicare reassignment NPD Authorized official
• National Kidney Partners, LLP

  • Nephrology Physician
  • Hudson, FL
  • NPI 1780684795
  Medicare reassignment Care Compare group NPD
• Metro Infectious Disease Consultants, LLC

  • Infectious Disease Physician
  • Burr Ridge, IL
  • NPI 1235125717

  FL

  Medicare reassignment NPD
• Metro Infectious Disease Consultants LLC

  • Infectious Disease Physician
  • Jonesboro, GA
  • NPI 1770307191
  NPD
• Kidney Clinic of Jacksonville, LLC

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1427281971
  NPD (past)
• Comprehensive Renal Care, PC

  • Nephrology Physician
  • Philadelphia, PA
  • NPI 1861827305
  NPD (past)
• Philadelphia Hypertension & Nephrology Consultants PC

  • Nephrology Physician
  • Philadelphia, PA
  • NPI 1336229897
  NPD (past)
• Springfield Clinic, LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1780638478
  NPD (past)

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

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jacksonville, FL
  • NPI 1255587531

  Dialysis facility

  Care Compare affiliation Name & address match
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jacksonville, FL
  • NPI 1831477173

  Dialysis facility

  Care Compare affiliation Name & address match
• Total Renal Care, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Middleburg, FL
  • NPI 1174939896

  Dialysis facility

  Care Compare affiliation Name & address match
• Memorial Healthcare Group Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1447206438
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1407937170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 409",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585237",
            "telephone_number": "904-400-6800",
            "fax_number": "904-400-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 409",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585237",
            "telephone_number": "904-400-6800",
            "fax_number": "904-400-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANCHA",
        "first_name": "KOTESWARI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "98954",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "98954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briley Jane Kaminski, MS, RDN
• Katelyn Marie Kaminsky, BCBA
• Evan Kamperman, M.D.
• Kaitlin Kamrowski, D.O.
• Ozdemir Yusef Kanar, M.D.
• Ravi Kumar Kancha, MD
• Dipti Kanchan, DMD
• Arline Jose Kandathiparampil, M.D.
• Pujan Kandel, MD
• Stephen Kandilas, MD

• Nephrology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.