Edson Mwakyanjala, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

ME140140 Issued in FL

Practice address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Phone

(904) 953-2000

NPI assigned

May 11, 2017

Last updated

Jun 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in FL, AZ, WI3 enrollments

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 3

Specialty

Hospitalist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo Clinic JacksonvilleGroup PAC ID 5698689297, shared by 6 NPIs, 1,595 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Hospital, Jacksonville, FL, CCN 100151

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mayo Clinic Jacksonville

  dba Mayo Clinic Jacksonville advanced care at home

  • Health Service Clinic/Center
  • Jacksonville, FL
  • NPI 1174143986

  WI

  Medicare reassignment NPD
• Mayo Clinic Jacksonville

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1790772317

  AZ

  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System in Eau Claire

  • Multi-Specialty Clinic/Center
  • Eau Claire, WI
  • NPI 1235588831
  Medicare reassignment NPD
• Mayo Clinic Jacksonville

  dba Mayo Clinic Home Infusion Pharmacy

  • Home Infusion Therapy Pharmacy
  • Jacksonville, FL
  • NPI 1003510116
  NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System - Oakridge in Mondovi

  • Rural Health Clinic/Center
  • Mondovi, WI
  • NPI 1174116669
  NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System-Barron

  • Critical Access Hospital
  • Barron, WI
  • NPI 1740239557
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mayo Clinic Florida

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1891782470
  Care Compare affiliation

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1982130753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13400 E Shea Blvd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852595499",
            "country_code": "US",
            "telephone_number": "480-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MWAKYANJALA",
        "first_name": "EDSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN24728",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "66123",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "77871",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME140140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emwakyanjala391557@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emwakyanjala391557@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karthik Muthusamy, MD
• Sahilpreet Kaur Mutti
• Sudha Rani Mutyala, MD
• Elizabeth Gatch Mutz, DNP, APRN
• Charles Muzondi, MD
• My Care of North Florida
• My Care of North Florida LLC
• My Choice Operating Company LLC (Mobile Medical)
• My Dentist and Associates, P.a.
• My Father's House Support Services LLC

• Hospitalist Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Hospitalist Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.