Individual provider Active NPI

Mukesh Chandra Agarwal, M.D.

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1467480780
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME132766 Issued in FL
Practice address
145 Heron Bay Rd
Jacksonville, FL 32218-3595
Phone
(866) 793-4591
NPI assigned
Jun 28, 2006
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME132766 FL Primary

Addresses

Primary practice location

145 Heron Bay Rd
Jacksonville, FL 32218-3595

Mailing address

145 Heron Bay Rd
Jacksonville, FL 32218-3595
Phone (866) 793-4591

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
I20220622002228 FL Practitioner - Internal Medicine 0840227021 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME132766FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Senior Medical Centers of Florida, LLC CurrentSince Oct 16, 2022 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jul 1, 2022 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jul 1, 2022 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Oct 16, 2022 Accepting new patients
McKinney Medical Center Inc Past Accepting new patients
Mayo Clinic Health System in Waycross, Inc. Past Accepting new patients
Gainesville Vamc PastSince Apr 9, 2024 Accepting new patients

Locations

3059 Edgewood Ave W
Jacksonville, FL 32209
Phone (904) 647-3180

3614 Blanding Blvd
Jacksonville, FL 32210
Phone (904) 419-7100

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

Networks

  • Freedom Health HMO Network

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1467480780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HERON BAY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322183595",
            "telephone_number": "866-793-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HERON BAY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322183595",
            "telephone_number": "866-793-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGARWAL",
        "first_name": "MUKESH",
        "middle_name": "CHANDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME132766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.