Individual provider Active NPI

Jeffrey Anthony Sugandi, M.D.

  • Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1477992279
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME176659 Issued in FL
Practice address
653 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 383-1015
Fax
(904) 244-7454
NPI assigned
Jun 14, 2013
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 310138 NY
Surgery Physician 208600000X 57101 AZ
Surgery Physician 208600000X MD-49785 IA
Surgery Physician 208600000X ME176659 FL Primary

Addresses

Primary practice location

653 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

653 W 8TH St
2ND Floor Faculty Clinic
Jacksonville, FL 32209-6511
Phone (904) 383-1015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20220819000383 IA Practitioner - General Surgery 4981955770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Minnesota Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center IncGroup PAC ID 0244148732, 234 clinicians

Practice addresses (Care Compare)

226 Bluebell Rd
Cedar Falls, IA 50613-6328
Phone (319) 575-5800

2710 Saint Francis Dr
Waterloo, IA 50702-5619
Phone (319) 272-5000

2710 Saint Francis Dr
Waterloo, IA 50702-5634
Phone (319) 272-5000

3421 W 9TH St
Waterloo, IA 50702-5401

515 College St
Cedar Falls, IA 50613-2500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Mastectomy33
Melanoma (skin cancer) excision18
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57101AZMDSurgery Physician
310138NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center Inc CurrentSince Aug 15, 2022 Accepting new patients
Covenant Medical Center, Inc. CurrentSince Aug 15, 2022 Accepting new patients
Covenant Medical Center Inc Past Accepting new patients

Locations

751 Main St
Arlington, IA 50606
Phone (563) 633-6965

226 Bluebell Rd
Cedar Falls, IA 50613
Phone (319) 575-5800

200 E Ridgeway Ave
Ste 400
Waterloo, IA 50702
Phone (319) 272-2070

2710 Saint Francis Dr
Ste 410
Waterloo, IA 50702

3421 W 9th St
Waterloo, IA 50702
Phone (319) 272-7050

Interoperability endpoints

  • Direct secure messaging: jsugandi3936729@direct.trinity-health.org

Organizations & group practices 3

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 4

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": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1477992279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 W 8TH ST",
            "address_2": "2ND FLOOR FACULTY CLINIC",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-383-1015",
            "fax_number": "904-244-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-383-1015",
            "fax_number": "904-244-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGANDI",
        "first_name": "JEFFREY",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-14",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "310138",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "57101",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "MD-49785",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME176659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.