Individual provider Active NPI

Ramesh M Kotihal, M.D.

  • Nephrology Physician
  • Orange Park, FL
National Provider Identifier
1811055080
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME103955 Issued in FL
Practice address
1563 Kingsley Avenue
Suite 106
Orange Park, FL 32073
Phone
(904) 272-6161
Fax
(904) 389-5332
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 51437-20 WI
Internal Medicine Physician 207R00000X 51437-20 WI
Nephrology Physician 207RN0300X ME103955 FL Primary

Addresses

Primary practice location

1563 Kingsley Avenue
Suite 106
Orange Park, FL 32073

Mailing address

2 Shircliff Way
Suite 700 Depaul BLDG.
Jacksonville, FL 32204-4763
Phone (904) 389-5333

Other identifiers 1

IdentifierTypeStateIssuer
001479700MedicaidFL

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
I20091107000008 FL Practitioner - NephrologyPractitioner - Internal Medicine 6204909195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
James D Baker III MD PAGroup PAC ID 9032011663, 19 clinicians

Practice addresses (Care Compare)

2 Shircliff Way
Jacksonville, FL 32204-4759
Phone (904) 389-5333

2 Shircliff Way
Suite 415
Jacksonville, FL 32204-4763

2 Shircliff Way 700 Depaul BLDG
Nephrology Associates of Northeast
Jacksonville, FL 32204-4759
Phone (904) 389-5333

Hospital & facility affiliations

  • Northeast Florida Dialysis Center Dialysis facility, Orange Park, FL, CCN 102591
  • Orange Park Kidney Center Dialysis facility, Orange Park, FL, CCN 102756
  • HCA Florida Orange Park Hospital Hospital, Orange Park, FL, CCN 100226
  • Ascension St Vincent'S Clay County Hospital, Middleburg, FL, CCN 100321
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
James D. Baker III, M.D., PA Nephrology CurrentSince Aug 1, 2009 Accepting new patients
Florida Infectious Disease Associates PA PastSince Apr 21, 2024 Accepting new patients

Locations

2 Shircliff Way
Ste 700
Jacksonville, FL 32204
Phone (904) 387-3001

2 Shircliff Way
Ste 415
Jacksonville, FL 32204
Phone (904) 389-5333

1658 St Vincents Way
Ste 340
Middleburg, FL 32068
Phone (904) 269-6526

1563 Kingsley Ave
Ste 106
Orange Park, FL 32073
Phone (904) 272-6161

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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 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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1811055080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY",
            "address_2": "SUITE 700 DEPAUL BLDG.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044763",
            "telephone_number": "904-389-5333",
            "fax_number": "904-389-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1563 KINGSLEY AVENUE",
            "address_2": "SUITE 106",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32073",
            "telephone_number": "904-272-6161",
            "fax_number": "904-389-5332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTIHAL",
        "first_name": "RAMESH",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WI",
            "license": "51437-20",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "51437-20",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME103955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001479700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.