Shashi Chetan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME91712 Issued in FL

Practice address

820 Prudential Dr Ste 304
Credentialing Department
Jacksonville, FL 32207-8205

Phone

(904) 346-3649

Fax

(904) 348-5627

NPI assigned

Jul 10, 2006

Last updated

Feb 3, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Internal Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hni Hospital Services of Florida LLCGroup PAC ID 0244661353, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent's Southside Hospital, Jacksonville, FL, CCN 100307

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Hni Hospital Services of Florida, LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Panama City, FL
  • NPI 1144851411
  Medicare reassignment Care Compare group NPD
• Hni Medical Services of Florida, LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1679048284
  Medicare reassignment NPD
• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1508817529

  Internal Medicine

  NPD (past)
• The New London Hospital Association, Inc.

  dba Newport Health Center

  • Multi-Specialty Clinic/Center
  • Newport, NH
  • NPI 1770684672
  NPD (past)

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

• St Lukes - St Vincents Healthcare

  dba Ascension St. Vincent's Southside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747
  Care Compare affiliation

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1417980434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40767",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322030767",
            "telephone_number": "904-376-3707",
            "fax_number": "904-391-5807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR STE 304",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078205",
            "telephone_number": "904-346-3649",
            "fax_number": "904-348-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHETAN",
        "first_name": "SHASHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME91712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00364691",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2711478-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl Renee Chesser
• Leah Chesser, RPA
• Albert Duane Chester II, PHARM. D.
• Kellie Derae Chestnut, ITDS, M.A.E.
• Suzanne M Chestnut, APRN
• Joseph Yee Kwan Cheung, M.D.
• Constantino Cheuy, RPH
• Hardik Chhatrala, MD
• Jessica Lauren CHI, DDS
• Catherine Chiafair, DMD

• Internal Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; 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.