Individual provider Active NPI

Kanupriya Mathur, M.D.

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1679885248
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME169656 Issued in FL
Practice address
8614 Baymeadows Way Ste 100
Jacksonville, FL 32256-8236
Phone
(904) 396-0450
Fax
(904) 390-7422
NPI assigned
Jul 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X S9744 TX
Internal Medicine Physician 207R00000X 0101260240 VA
Internal Medicine Physician 207R00000X ME169656 FL Primary

Addresses

Primary practice location

8614 Baymeadows Way Ste 100
Jacksonville, FL 32256-8236

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-2092

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
I20241018003734 FL Practitioner - Internal Medicine 3476796590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

8614 Baymeadows Way
Suite 100
Jacksonville, FL 32256-8236
Phone (904) 396-0450

Hospital & facility affiliations

  • Baptist Home Health Care by Bayada Home health agency, Jacksonville, FL, CCN 107482
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S9744TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc CurrentSince Nov 1, 2024 Accepting new patients
Baptist Primary Care Inc Internal Medicine CurrentSince Nov 1, 2024 Accepting new patients

Locations

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

8614 Baymeadows Way
#100
Jacksonville, FL 32256
Phone (904) 396-0450

Interoperability endpoints

  • Direct secure messaging: kmathur209099@baptisthealthsystemjacksonville.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1278806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1679885248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8614 BAYMEADOWS WAY STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322568236",
            "telephone_number": "904-396-0450",
            "fax_number": "904-390-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHUR",
        "first_name": "KANUPRIYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-11",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S9744",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101260240",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME169656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.