NPIMap

Individual provider Active NPI

Malhar Agarwal, MD

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1942690193
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME127170 Issued in FL
Practice address
4205 Belfort Rd Ste 3075
Jacksonville, FL 32216-1475
Phone
(904) 296-5785
Fax
(904) 296-4786
NPI assigned
Jan 27, 2015
Last updated
May 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME127170 FL Primary

Addresses

Primary practice location

4205 Belfort Rd Ste 3075
Jacksonville, FL 32216-1475

Mailing address

655 West 8TH Street, Acc BLDG 5TH Floor C-35
Jacksonville, FL 32209
Phone (904) 383-1011

Other practice location 1

8900 Van Wyck Expressway
Jamaica, NY 11418
Phone (718) 206-6777

Other identifiers 1

IdentifierTypeStateIssuer
018793900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 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
I20161114000773 FL Practitioner - Internal Medicine 3779862891 Reassigns benefits to 3 organizations
I20190531000935 GA Practitioner - Internal Medicine 3779862891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent's Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

4205 Belfort Rd
Suite 3075
Jacksonville, FL 32216-1475
Phone (904) 308-7790

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285130NYMDLicensed Practical Nurse
ME127170FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Sep 26, 2016 Accepting new patients
St Vincents Ambulatory Care Inc Internal Medicine CurrentSince Dec 15, 2020 Accepting new patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince May 1, 2019 Accepting new patients
Apogee Medical Group Georgia Inc Internal Medicine CurrentSince Dec 15, 2019 Accepting new patients
Hni Medical Services of Florida, LLC Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Dec 15, 2020 Accepting new patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Sep 26, 2016 Accepting new patients

Locations

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

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

4205 Belfort Rd
Ste 3004
Jacksonville, FL 32216
Phone (904) 296-4977

4205 Belfort Rd
Ste 3075
Jacksonville, FL 32216
Phone (904) 296-5785

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

655 W 8th St
Bldg 5TH
Jacksonville, FL 32209
Phone (904) 244-2636

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-5600

7500 Rialto Blvd
Ste 1-140
Austin, TX 78735

Interoperability endpoints

  • Direct secure messaging: malhar.agarwal.1@8967.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 9

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": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1942690193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 WEST 8TH STREET, ACC BLDG 5TH FLOOR C-35",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32209",
            "telephone_number": "904-383-1011",
            "fax_number": "904-244-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 3075",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161475",
            "telephone_number": "904-296-5785",
            "fax_number": "904-296-4786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 Van Wyck Expressway",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "11418",
            "country_code": "US",
            "telephone_number": "718-206-6777",
            "fax_number": "718-206-6651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGARWAL",
        "first_name": "MALHAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-27",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME127170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018793900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.