PAUL D JAYACHANDRA M D P A NPI 1295870830

NPI Information

NPI: 1295870830
Provider Name: PAUL D JAYACHANDRA M D P A
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1680 OSCEOLA ELEMENTARY SCHOOL ROAD
SUITE A
ST AUGUSTINE, FL
ZIP 32084
Phone: (904) 824-7476
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PAUL D JAYACHANDRA M D P A is a specialist in St Augustine, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PAUL D JAYACHANDRA M D P A NPI is 1295870830. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1680 OSCEOLA ELEMENTARY SCHOOL ROAD
SUITE A
ST AUGUSTINE, FL
ZIP 32084
Phone: (904) 824-7476
Fax: (904) 824-7870

The provider's authorized official is Jennifer Rae Faircloth .
The authorized official title is Office Manager and has the following contact phone number (904) 824-7476.

The enumeration date for this NPI number is 2/21/2007 and was last updated on 10/22/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		ME0066989	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	390006717	OTHER	FLORIDA	RAILROAD MEDICARE
2	150095	OTHER	FLORIDA	HEALTHEASE
3	94163841	OTHER	FLORIDA	WAUSA BENIFITS
4	F41881	MEDICARE UPIN	FLORIDA
5	26220A	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA
6	AA919	OTHER	FLORIDA	MEDICARE PTAN
7	26220Y	OTHER	FLORIDA	MEDICARE PTAN NUMBER
8	110132302	OTHER	FLORIDA	UNITED HEALTHCARE
9	5777008	OTHER	FLORIDA	AETNA
10	376531801	MEDICAID	FLORIDA
11	376531800	MEDICAID	FLORIDA
12	150095	OTHER	FLORIDA	WELLCARE
13	206068	OTHER	FLORIDA	AVMED
14	26220Y	OTHER	FLORIDA	MEDICARE PROVIDER NUMBER
15	26220Y	MEDICARE PIN	FLORIDA
16	26220	OTHER	FLORIDA	BCBS FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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