Individual provider Active NPI

Madhavi Jakkula, M.D

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1639301328
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME113523 Issued in FL
Practice address
9400 Tukey Lake Rd
MP 452
Orlando, FL 32819
Phone
(321) 843-5500
Fax
(321) 843-5550
NPI assigned
Aug 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME113523 FL Primary
Hospitalist Physician 208M00000X ME113523 FL

Addresses

Primary practice location

9400 Tukey Lake Rd
MP 452
Orlando, FL 32819

Mailing address

9400 Tukey Lake Rd
MP 452
Orlando, FL 32819
Phone (321) 843-5500

Other identifiers 2

IdentifierTypeStateIssuer
005984700MedicaidFL
ME113523OtherFLMEDICAL LICENSE

Other names 1

  • Mrs. Madhavi Jakkula Professional name

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
I20121001000089 FL Practitioner - Internal Medicine 6103075551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

9400 Turkey Lake Rd
Orlando, FL 32819-8001
Phone (407) 354-1202

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Dec 1, 2014 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Dec 1, 2014 Accepting new patients
Orlando Health, Inc. Current Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: mjakkula25970@orlandohealth.medalliesdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1639301328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 TUKEY LAKE RD",
            "address_2": "MP 452",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32819",
            "telephone_number": "321-843-5500",
            "fax_number": "321-843-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 TUKEY LAKE RD",
            "address_2": "MP 452",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32819",
            "telephone_number": "321-843-5500",
            "fax_number": "321-843-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKKULA",
        "first_name": "MADHAVI",
        "name_prefix": "Mrs.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-14",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME113523",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME113523",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005984700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME113523",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADHAVI",
            "last_name": "JAKKULA",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.