Individual provider Active NPI

Daycha Cheanvechai, MD

  • Emergency Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1851356265
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME76415 Issued in FL
Practice address
3625 University Blvd S
Emergency Department
Jacksonville, FL 32216-4207
Phone
(904) 399-6156
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME76415 FL Primary

Addresses

Primary practice location

3625 University Blvd S
Emergency Department
Jacksonville, FL 32216-4207

Mailing address

9745 Touchton Rd
Unit 3107
Jacksonville, FL 32246-4487
Phone (904) 399-6156

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
I20100907000915 FL Practitioner - Emergency Medicine 3577687995 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Jan 1, 2016 Accepting new patients
Florida Em-I Medical Services, PA Emergency Medicine Past Accepting new patients
Florida Em-I Medical Services PA Emergency Medicine Past Accepting new patients
Florida Em-I Medical Services, PA Emergency Medicine Past Accepting new patients

Locations

6477 103rd St
Jacksonville, FL 32210
Phone (904) 639-8517

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

11850 Atlantic Blvd
Jacksonville, FL 32225
Phone (904) 702-1330

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

23186 Blue Star Hwy
Quincy, FL 32351
Phone (850) 875-5977

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851356265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9745 TOUCHTON RD",
            "address_2": "UNIT 3107",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322464487",
            "telephone_number": "904-399-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UNIVERSITY BLVD S",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164207",
            "telephone_number": "904-399-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEANVECHAI",
        "first_name": "DAYCHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME76415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.