NPIMap

Individual provider Active NPI

Shalika Basnayake Katugaha, MD

  • Infectious Disease Physician
  • Jacksonville, FL
National Provider Identifier
1780824367
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME147258 Issued in FL
Practice address
820 Prudential Dr Ste 515
Jacksonville, FL 32207-8207
Phone
(904) 396-4886
Fax
(904) 398-0496
NPI assigned
Feb 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 0101241286 VA
Infectious Disease Physician 207RI0200X ME147258 FL Primary

Addresses

Primary practice location

820 Prudential Dr Ste 515
Jacksonville, FL 32207-8207

Mailing address

PO Box 45443
Salt Lake City, UT 84145-0443
Phone (904) 202-1032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171031002405 VA Practitioner - Infectious DiseasePractitioner - Internal Medicine 8123173770 Reassigns benefits to 1 organization
I20210415000618 FL Practitioner - Infectious Disease 8123173770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Georgetown University School of Medicine, 2004
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)

820 Prudential Dr
Suite 515
Jacksonville, FL 32207-8207
Phone (904) 396-4886

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME147258FLMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc CurrentSince Jun 7, 2021 Accepting new patients
Baptist Primary Care Inc Infectious Disease CurrentSince Jun 7, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1340 S 18th St
Ste 202A
Fernandina Beach, FL 32034
Phone (904) 202-4325

1747 Baptist Clay Dr
Ste 250A
Fleming Island, FL 32003
Phone (904) 202-4325

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

820 Prudential Dr
Ste 515
Jacksonville, FL 32207
Phone (904) 396-4886

836 Prudential Dr
Ste 105A
Jacksonville, FL 32207
Phone (904) 202-4325

14534 Old Saint Augustine Rd
Ste 3110A
Jacksonville, FL 32258
Phone (904) 202-4325

1320 Roberts Dr
Ste 105A
Jacksonville Beach, FL 32250
Phone (904) 202-4325

Interoperability endpoints

  • Direct secure messaging: skatugaha28287@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 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": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1780824367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45443",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841450443",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR STE 515",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078207",
            "telephone_number": "904-396-4886",
            "fax_number": "904-398-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATUGAHA",
        "first_name": "SHALIKA",
        "middle_name": "BASNAYAKE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-23",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "VA",
            "license": "0101241286",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME147258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.