Individual provider Active NPI

Katriin Kivilo

  • Emergency Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1891255568
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS18957 Issued in FL
Practice address
655 W 8TH St # C506
Jacksonville, FL 32209-6511
Phone
(904) 244-3817
NPI assigned
Mar 20, 2019
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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 OS18957 FL Primary

Addresses

Primary practice location

655 W 8TH St # C506
Jacksonville, FL 32209-6511

Mailing address

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (904) 308-7300

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
I20220816003223 FL Practitioner - Emergency Medicine 6800138355 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS18957FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anava Emergency Consultants LLC CurrentSince Jul 19, 2024 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jun 21, 2023 Accepting new patients
Cep America, LLC Emergency Medicine Current Accepting new patients
Emergency Medical Specialists of Jacksonville Emergency Medicine CurrentSince Jul 1, 2022 Accepting new patients
Baker County Medical Services Inc CurrentSince Jul 1, 2024 Accepting new patients
Baker County Medical Services, Inc Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jun 21, 2023 Accepting new patients
Anava Hospitalists LLC Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

159 N 3rd St
Macclenny, FL 32063
Phone (904) 259-7815

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1891255568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044748",
            "telephone_number": "904-308-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST # C506",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-3817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIVILO",
        "first_name": "KATRIIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS18957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.