Kethandapatti Chakravarthy Balaji, MBBS

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME137242 Issued in FL

Practice address

655 W 8TH St
Jacksonville, FL 32209-6511

Phone

(904) 383-1016

NPI assigned

May 19, 2006

Last updated

Nov 14, 2018By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, 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

Specialty

Urology

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

Merit-based Incentive Payment System (MIPS)

Final score

59.59 of 100Reported as apm

Quality

59.93

Promoting interoperability

0

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbalaji339571@direct.shands.ufl.edu

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.

• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452
  Medicare reassignment Care Compare group NPD
• University of Florida Jacksonville Physicians Inc

  • Surgery Physician
  • Jacksonville, FL
  • NPI 1588824858
  NPD
• University of Florida Jacksonville Physicians, Inc.

  dba UF Health Imaging Center-Baymeadows

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD
• Siu Physicians & Surgeons, Inc

  dba SIU HealthCare

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989
  NPD (past)
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373
  NPD (past)

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

• Shands Jacksonville Medical Center Inc

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1144962408

  Hospital

  Care Compare affiliation
• Shands Jacksonville Medical Center Inc

  dba Shands Jacksonville

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1821186313
  Care Compare affiliation

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1558314484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-383-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-383-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALAJI",
        "first_name": "KETHANDAPATTI",
        "middle_name": "CHAKRAVARTHY",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2010-01458",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME137242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5915217",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sumer Bakirci
• Emily Bakker, PT, DPT, NCS
• Chloe Elizabeth Bakkum
• Nadia Bakor, M.D.
• Vikram Aditya Bala, DPM
• Balance Chiropractic Center, Inc.
• Helen Balanoba, RPT
• Stefanie Masinsin Balanza
• Halle Balassaitis
• Prasanth Balasubramanian, MD

• Urology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.