Individual provider Active NPI

Samidha Shreyas Bhat, MD

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1982896940
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME147175 Issued in FL
Practice address
1731 University Blvd S
Jacksonville, FL 32216-8928
Phone
(904) 725-0200
NPI assigned
Aug 14, 2007
Last updated
Feb 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME147175 FL Primary

Addresses

Primary practice location

1731 University Blvd S
Jacksonville, FL 32216-8928

Mailing address

1731 University Blvd S
Jacksonville, FL 32216-8928
Phone (904) 725-0200

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
I20200923001456 FL Practitioner - Family PracticePractitioner - Hospice/Palliative Care 8426244666 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospice/Palliative Care
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, shared by 5 NPIs, 908 clinicians

Practice addresses (Care Compare)

1155 E 21St St
Jacksonville, FL 32206-2401
Phone (904) 359-9067

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-7874

655 W 8TH St
Jacksonville, FL 32209-6511

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME147175FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc CurrentSince Jul 1, 2024 Accepting new patients
University of Florida Jacksonville Physicians Inc Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Oct 1, 2022 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Family Medicine Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
University of Florida Jacksonville Physicians, Inc. Family Medicine Past Accepting new patients

Locations

6420 W Newberry Rd
Ste 100
Gainesville, FL 32605
Phone (352) 332-3900

1155 E 21st St
Jacksonville, FL 32206
Phone (904) 359-9067

1255 Lila St
Jacksonville, FL 32208
Phone (904) 244-5700

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

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

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 2

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": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1982896940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168928",
            "telephone_number": "904-725-0200",
            "fax_number": "904-721-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168928",
            "telephone_number": "904-725-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAT",
        "first_name": "SAMIDHA",
        "middle_name": "SHREYAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME147175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.