NPIMap

Individual provider Active NPI

Pranjal Jain, MD

  • Nephrology Physician
  • Temple Terrace, FL
National Provider Identifier
1730408121
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME121344 Issued in FL
Practice address
12662 Telecom Dr
Temple Terrace, FL 33637-0935
Phone
(813) 910-8708
Fax
(855) 852-7153
NPI assigned
May 25, 2010
Last updated
Apr 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME121344 FL Primary

Addresses

Primary practice location

12662 Telecom Dr
Temple Terrace, FL 33637-0935

Mailing address

409 Bayshore Blvd
Tampa, FL 33606-2707
Phone (813) 844-5470

Other identifiers 1

IdentifierTypeStateIssuer
014122500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150121000955 FL Practitioner - Nephrology 4880866037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

409 Bayshore Blvd
FL 4
Tampa, FL 33606-2707
Phone (813) 910-8708

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
70.52
Promoting interoperability
100
Improvement activities
40
Cost
73.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Florida Kidney Physicians , LLC Nephrology CurrentSince Oct 11, 2016 Accepting new patients
Florida Kidney Physicians, LLC Nephrology CurrentSince Oct 11, 2016 Accepting new patients
Ashutosh S Lohe MD PSC Nephrology Past Accepting new patients

Locations

2001 W Reynolds St
Plant City, FL 33563
Phone (813) 655-1100

2501 Paul Buchman Hwy
Ste A
Plant City, FL 33563

409 Bayshore Blvd
Tampa, FL 33606
Phone (813) 253-2640

409 Bayshore Blvd
Fl 4
Tampa, FL 33606
Phone (813) 910-8708

4710 N Habana Ave
Ste 107
Tampa, FL 33614
Phone (813) 870-3767

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

27802 Summergate Blvd
Wesley Chapel, FL 33544

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: pjain86178@direct.tgh.org
  • Direct secure messaging: pranjal.jain.1@15644.direct.athenahealth.com

Organizations & group practices 4

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 7

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": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1730408121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 BAYSHORE BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062707",
            "telephone_number": "813-844-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12662 TELECOM DR",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370935",
            "telephone_number": "813-910-8708",
            "fax_number": "855-852-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "PRANJAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-25",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME121344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014122500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.