| Prabodh Ranjan, MD | |
|
820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205 | |
| (904) 346-3649 | |
| (904) 348-5627 |
| Full Name | Prabodh Ranjan |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 29 Years |
| Location | 820 Prudential Dr Ste 304, Jacksonville, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245417609 | NPI | - | NPPES |
| 2805138-00 | Medicaid | FL | |
| P00712859 | Other | FL | MEDICARE RR |
| 139901302A | Medicaid | GA | |
| K1951A | Other | FL | BPC MCR GROUP NO. |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RN0300X | Internal Medicine - Nephrology | ME99514 (Florida) | Secondary |
| 207R00000X | Internal Medicine | ME99514 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bma - Jacksonville | Jacksonville, FL | Dialysis facility |
| Fmc Dialysis Services - North Jacksonville | Jacksonville, FL | Dialysis facility |
| Jacksonville Westside Dialysis | Jacksonville, FL | Dialysis facility |
| Baptist Health Medical Center - Jacksonville | Jacksonville, FL | Hospital |
| Ascension St Vincent's Riverside | Jacksonville, FL | Hospital |
| Baptist Medical Center Beaches | Jacksonville beach, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Florida Kidney Physicians Llc | 4385925650 | 153 |
| Entity Name | Florida Kidney Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760831564 PECOS PAC ID: 4385925650 Enrollment ID: O20161228000460 |
| Mailing Address | Practice Location Address |
|---|---|
| Prabodh Ranjan, MD Po Box 44004, Jacksonville, FL 32231-4004 Ph: (904) 346-3649 | Prabodh Ranjan, MD 820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205 Ph: (904) 346-3649 |
Dr. Jami Ann Rothe Kinnucan, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 | |
Michelle Tulang, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 | |
Dr. Minnsun Koh Park, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3900 University Blvd S, Jacksonville, FL 32216 Phone: 904-222-6656 | |
Sandrela Mussallam Abu Shaibeh, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 820 Prudential Dr Ste 304, Jacksonville, FL 32207 Phone: 904-202-3860 Fax: 904-202-3846 | |
Krunal Patel, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4800 Belfort Rd, Jacksonville, FL 32256 Phone: 904-398-7205 Fax: 904-396-4047 | |
Zaid Abdel Rahman, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 | |
Sina O'sullivan, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 |