Individual provider Active NPI

Geetanjali Kimteelal Dang, MD

  • Cardiovascular Disease Physician
  • Jacksonville, FL
National Provider Identifier
1760770291
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME156868 Issued in FL
Practice address
836 Prudential Dr Ste 1700
Jacksonville, FL 32207-8344
Phone
(904) 398-0125
Fax
(904) 376-3206
NPI assigned
Jul 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 62045 WI
Cardiovascular Disease Physician 207RC0000X ME156868 FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 1700
Jacksonville, FL 32207-8344

Mailing address

PO Box 746652
Atlanta, GA 30374-6652
Phone (904) 202-2092

Other identifiers 1

IdentifierTypeStateIssuer
1760770291MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, 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
I20140911001907 WI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Hospitalist 9830318575 Reassigns benefits to 2 organizations
I20220824003409 FL Practitioner - Cardiovascular Disease (Cardiology) 9830318575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Cardiology, Inc.Group PAC ID 2466614581, 98 clinicians

Practice addresses (Care Compare)

836 Prudential Dr
Suite 1700
Jacksonville, FL 32207-8344
Phone (904) 398-0125

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62045WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Cardiology, Inc. Cardiovascular Disease CurrentSince Aug 15, 2022 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Apr 18, 2020 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Internal Medicine Current Accepting new patients

Locations

11236 Baptist Health Dr
Ste 310
Jacksonville, FL 32218
Phone (904) 224-9303

836 Prudential Dr
Ste 1700
Jacksonville, FL 32207
Phone (904) 398-0125

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533

Interoperability endpoints

  • Direct secure messaging: gdang115442@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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1760770291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746652",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746652",
            "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": "836 PRUDENTIAL DR STE 1700",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078344",
            "telephone_number": "904-398-0125",
            "fax_number": "904-376-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "GEETANJALI",
        "middle_name": "KIMTEELAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "62045",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME156868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760770291",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.