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PRASHANT JANI M.D
NPI 1255489993
Internal Medicine in Sanford, FL

Active since January 08, 2007PECOS EnrolledAccepts Medicare Assignment
1403 MEDICAL PLAZA DR STE 106, SANFORD, FL 32771(219) 230-2091 Get Directions Write a Review

NPPES record last updated: September 27, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 27, 2022, Sep 19, 2022, Jun 14, 2019 (3 updates tracked since 2019).

About Prashant Jani M.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRASHANT JANI M.D (NPI 1255489993) is an individual internal medicine provider in Sanford, Florida, licensed in Florida (FLME114445) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Oviedo Medical Center, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1255489993
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NamePRASHANT JANICredential: M.D
Location Address1403 MEDICAL PLAZA DR STE 106Sanford, FL 32771-1085
Mailing Address3300 S Fiske BlvdRockledge, FL 32955-4306 · (407) 328-1575
Phone(219) 230-2091
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateJanuary 8, 2007
Last NPPES UpdateSeptember 27, 20223 updates tracked since enumeration
NPPES CertifiedSeptember 27, 2022
✔ NPI 1255489993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · FLME114445
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1403 MEDICAL PLAZA DR STE 106, Sanford, FL 32771
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Other Identifiers 1

OtherPV664FL · Medicare Hf

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Prashant Jani M.d is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3476788902
PECOS Enrollment IDI20150706000919
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

5

Medicare enrollment records show Prashant Jani reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Home Visiting Physicians, LLC
35 mi
Family Medicine
2120 MICHIGAN AVE
Kissimmee, FL 34744
  • Reassigned Medicare billing, Florida enrollment
  • 7 clinicians in this Medicare group
NPI 1235363375 (407) 483-8944
Doctor House Call LLC
35 mi
Family Medicine
2120 MICHIGAN AVE
Kissimmee, FL 34744
  • Reassigned Medicare billing, Florida enrollment
  • 3 clinicians in this Medicare group
NPI 1639640717 (407) 483-8944
Privia Medical Group Florida, LLC
66 mi
General Practice
140 6TH AVE
Indialantic, FL 32903
  • Reassigned Medicare billing, Florida enrollment
  • Medicare enrollment name: Health First Privia Medical Group
  • 329 clinicians in this Medicare group
NPI 1700649043 (321) 312-3501
Inpatient Consultants Of Florida Inc
91 mi
Hospitalist
3550 BUSCHWOOD PARK DR, SUITE 350
Tampa, FL 33618
  • Reassigned Medicare billing, Florida enrollment
  • 903 clinicians in this Medicare group
NPI 1457511164 (813) 936-5000
Hospital Medicine Services Of Fl, LLC
208 mi
Hospitalist
20900 BISCAYNE BLVD
Aventura, FL 33180
  • Reassigned Medicare billing, Florida enrollment
  • 861 clinicians in this Medicare group
NPI 1710684857 (305) 682-7000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
315 services75 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
37 services27 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
27 services27 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
25 services19 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
21 services14 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
19 services17 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Oviedo Medical Center

Acute Care Hospitals · Oviedo, FL
4/5 CMS rating
OwnershipProprietary
CMS Certification Number100329
Location8300 Red Bug Lake RdOviedo, FL 32765 · Seminole County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32771 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Medication Reconciliation Post-Discharge
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…
100%20 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers19 claims28 services$6.38 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers12 claims14 services$1.06 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers12 claims12 services$14.44 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TEJAS B PATEL MD
Internal Medicine
1403 MEDICAL PLAZA DR STE 106
SANFORD, FL 32771
Seminole County (407) 328-1575
P & T FAMILY CARE LLC
Internal Medicine
1403 MEDICAL PLAZA DR STE 106
SANFORD, FL 32771
Seminole County (407) 328-1575
MR. ANDREW FRANCIS OGARA ARNP
Nurse Practitioner
1403 MEDICAL PLAZA DR STE 106
SANFORD, FL 32771
Seminole County (407) 328-1575
DR. GAURAV PURANI M.D.
Internal Medicine
1403 MEDICAL PLAZA DR STE 106
SANFORD, FL 32771
Seminole County (407) 328-1575

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prashant Jani's NPI number?

The NPI number for Prashant Jani is 1255489993. It was assigned to this individual provider in the NPPES registry on January 8, 2007.

Where is Prashant Jani located?

Prashant Jani practices at 1403 Medical Plaza Dr Ste 106, Sanford, FL 32771. The listed phone number is (219) 230-2091.

What is Prashant Jani's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Prashant Jani enrolled in Medicare?

Yes. Prashant Jani is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Prashant Jani's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Prashant Jani reassigns Medicare benefits to 5 organizations: Home Visiting Physicians, LLC (Kissimmee, FL), Doctor House Call LLC (Kissimmee, FL), Privia Medical Group Florida, LLC (Indialantic, FL), Inpatient Consultants Of Florida Inc (Tampa, FL) and Hospital Medicine Services Of Fl, LLC (Aventura, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Prashant Jani's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Prashant Jani accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Cigna HealthCare of Florida, Inc. and Cigna Healthcare and 6 other insurers list Prashant Jani as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Prashant Jani affiliated with any hospitals?

According to CMS data, Prashant Jani is affiliated with Oviedo Medical Center.

When was this NPI record last updated?

The NPPES record for Prashant Jani was last updated on September 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.