Individual provider Active NPI

Avani Changela, MD

  • Hematology & Oncology Physician
  • Jacksonville, FL
National Provider Identifier
1740582246
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME154964 Issued in FL
Practice address
14546 Old Saint Augustine Rd Ste 100
Jacksonville, FL 32258-5468
Phone
(904) 202-7300
Fax
(904) 202-2754
NPI assigned
Dec 3, 2010
Last updated
Apr 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036.137765 IL
Hematology & Oncology Physician 207RH0003X ME154964 FL Primary

Addresses

Primary practice location

14546 Old Saint Augustine Rd Ste 100
Jacksonville, FL 32258-5468

Mailing address

PO Box 746654
Atlanta, GA 30374-6654
Phone (904) 202-2092

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address achangela141880@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, 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
I20150701001025 IL Practitioner - Hematology/OncologyPractitioner - Internal Medicine 6901118140 Reassigns benefits to 2 organizations
I20220524001535 FL Practitioner - Hematology/Oncology 6901118140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist MD Anderson Cancer Physicians IncGroup PAC ID 5991932063, 115 clinicians

Practice addresses (Care Compare)

14546 Old Saint Augustine Rd
Jacksonville, FL 32258-5468
Phone (904) 202-7300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME154964FLMDHematology & Oncology Physician
036.137765ILMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist MD Anderson Cancer Physicians Inc Hematology & Oncology CurrentSince Jun 1, 2022 Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Dec 18, 2017 Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Dec 18, 2017 Accepting new patients
Physician Services Corporation of Southern Illinois Inc. CurrentSince Dec 18, 2017 Accepting new patients

Locations

1301 Palm Ave
Jacksonville, FL 32207
Phone (844) 632-2278

14546 Old Saint Augustine Rd
Ste 105
Jacksonville, FL 32258
Phone (904) 271-6890

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

2 Good Samaritan Way
Ste 420
Mount Vernon, IL 62864
Phone (618) 899-4000

4117 Veterans Memorial Dr
Mount Vernon, IL 62864
Phone (618) 241-1827

605 N 12th St
Mount Vernon, IL 62864
Phone (618) 241-1108

Interoperability endpoints

  • Direct secure messaging: achangela141880@direct-ehr-ssmhc.com
  • Direct secure messaging: achangela52423@baptisthealthsystemjacksonville.direct-ci.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 2

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": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1740582246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746654",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746654",
            "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": "14546 OLD SAINT AUGUSTINE RD STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585468",
            "telephone_number": "904-202-7300",
            "fax_number": "904-202-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANGELA",
        "first_name": "AVANI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-03",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036.137765",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME154964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "achangela141880@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "achangela141880@direct-ehr-ssmhc.com",
            "address_1": "4117 Veterans Memorial Dr",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628646262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "4117 Veterans Memorial Dr",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628646262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.