Individual provider Active NPI

Clara L De Jesus Kalil, M.D.

  • General Practice Physician
  • Ocala, FL
National Provider Identifier
1528218971
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN812 Issued in FL
Practice address
7860 SW 103Rd St. Rd.
Ocala, FL 34476-8623
Phone
(352) 873-4458
Fax
(352) 873-8116
NPI assigned
Sep 23, 2008
Last updated
Mar 2, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN812 FL Primary

Addresses

Primary practice location

7860 SW 103Rd St. Rd.
Ocala, FL 34476-8623

Mailing address

PO Box 770719
Ocala, FL 34477-0719
Phone (352) 873-4458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091013000281 PR Practitioner - General Practice 6002952686 Practice locations: Quebradillas, PR
I20161202000171 FL Practitioner - Family Practice 6002952686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Countryside Medical PAGroup PAC ID 2860460318, 3 clinicians
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

7860 SW 103Rd St Rd
Suite 101
Ocala, FL 34476-8623
Phone (352) 873-4458

8449 SW Hwy 200
Ocala, FL 34481-9695
Phone (352) 693-3378

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN812FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Countryside Medical PA CurrentSince Aug 1, 2016 Accepting new patients
Town and Country Medical Inc Past Accepting new patients

Locations

7860 SW 103rd Street Rd
Ste 101
Ocala, FL 34476
Phone (352) 873-4458

Organizations & group practices 2

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": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1528218971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770719",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344770719",
            "telephone_number": "352-873-4458",
            "fax_number": "352-873-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7860 SW 103RD ST. RD.",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344768623",
            "telephone_number": "352-873-4458",
            "fax_number": "352-873-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS KALIL",
        "first_name": "CLARA",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.