NPIMap

Individual provider Active NPI

Dinesh Jayadevappa, M.D.

  • Nephrology Physician
  • Jacksonville, FL
National Provider Identifier
1467427492
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME75854 Issued in FL
Practice address
2585 Herschel St
Jacksonville, FL 32204-4557
Phone
(904) 388-2678
Fax
(904) 388-6776
NPI assigned
Feb 22, 2006
Last updated
Mar 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME75854 FL
Nephrology Physician 207RN0300X ME75854 FL Primary

Addresses

Primary practice location

2585 Herschel St
Jacksonville, FL 32204-4557

Mailing address

2585 Herschel St
Jacksonville, FL 32204-4557
Phone (904) 388-2678

Other identifiers 1

IdentifierTypeStateIssuer
254999900MedicaidFL

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
I20100306000299 FL Practitioner - NephrologyPractitioner - Internal Medicine 7315012606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

2585 Herschel St
Jacksonville, FL 32204-4557
Phone (904) 388-2678

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
70.52
Promoting interoperability
100
Improvement activities
40
Cost
73.91

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney Physicians , LLC Nephrology CurrentSince Jul 20, 2021 Accepting new patients
Florida Kidney Physicians, LLC Nephrology CurrentSince Jul 20, 2021 Accepting new patients
Bio-Medical Applications of Florida, Inc. PastSince Jan 25, 2011 Accepting new patients
Advanced Kidney Care Medical Associates, P.C. Nephrology PastSince Jul 17, 2021 Accepting new patients

Locations

1150 N 35th Ave
Ste 620
Hollywood, FL 33021
Phone (954) 612-8173

11236 Baptist Health Dr
Jacksonville, FL 32218
Phone (904) 202-6900

1201 Monument Rd
Ste 301
Jacksonville, FL 32225
Phone (800) 636-1701

2585 Herschel St
Jacksonville, FL 32204

7200 Normandy Blvd
Ste 20
Jacksonville, FL 32205
Phone (904) 378-8520

8245 Bayberry Rd
Jacksonville, FL 32256
Phone (904) 296-7775

905 Beach Blvd
#B
Jacksonville Beach, FL 32250
Phone (904) 246-4831

19056 NE 29th Ave
Miami, FL 33180
Phone (305) 354-4558

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dinesh.jayadevappa.1@15644.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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 11

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1467427492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 HERSCHEL ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044557",
            "telephone_number": "904-388-2678",
            "fax_number": "904-388-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 HERSCHEL ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044557",
            "telephone_number": "904-388-2678",
            "fax_number": "904-388-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYADEVAPPA",
        "first_name": "DINESH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME75854",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME75854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254999900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.