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DR. KETHANDAPATTI CHAKRAVARTHY BALAJI MBBS NPI 1558314484


NPI Information

NPI: 1558314484
Provider Name: DR. KETHANDAPATTI CHAKRAVARTHY BALAJI, MBBS
Classification: Urology - 208800000X
Entity Type: Individual

PECOS Registration: Yes

Address:
655 W 8TH ST
JACKSONVILLE, FL
ZIP 32209
Phone: (904) 383-1016
Get Directions

DR. Kethandapatti Chakravarthy Balaji, MBBS is an urology in Jacksonville, FL with 38 years of experience. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. DR. Kethandapatti Chakravarthy Balaji, MBBS NPI is 1558314484. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

655 W 8TH ST
JACKSONVILLE, FL
ZIP 32209-511
Phone: (904) 383-1016

The NPI 1558314484 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 11/14/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208800000XUrology2010-01458NORTH CAROLINANo
2208800000XUrologyME137242FLORIDAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15915217MEDICAIDNORTH CAROLINA

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: 4/28/2024

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