DR. SHASHI CHETAN MD
NPI 1417980434
Internal Medicine in Jacksonville, FL

Q: What is Shashi Chetan's NPI number?

The NPI number for Shashi Chetan is 1417980434. It was assigned to this individual provider in the NPPES registry on July 10, 2006.

Q: What is Shashi Chetan's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Shashi Chetan was last updated on February 3, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since July 10, 2006PECOS EnrolledAccepts Medicare Assignment

820 PRUDENTIAL DR STE 304, CREDENTIALING DEPARTMENT, JACKSONVILLE, FL 32207(904) 346-3649(904) 348-5627 Get Directions Write a Review

NPPES record last updated: February 3, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Shashi Chetan Md NPPES

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

DR. SHASHI CHETAN MD (NPI 1417980434) is an individual internal medicine provider in Jacksonville, Florida, licensed in Florida (ME91712) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension St Vincent's Southside, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1417980434

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. SHASHI CHETANCredential: MD

Location Address820 PRUDENTIAL DR STE 304, CREDENTIALING DEPARTMENTJacksonville, FL 32207-8205

Mailing AddressPo Box 40767, Credentialing DepartmentJacksonville, FL 32203-0767 · (904) 376-3707 · Fax (904) 391-5807

Phone(904) 346-3649

Fax(904) 348-5627

Sole ProprietorNo

Medical School CMSOtherGraduated 2003

Enumeration DateJuly 10, 2006

Last NPPES UpdateFebruary 3, 2015

✔ NPI 1417980434 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 · ME91712

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.

820 PRUDENTIAL DR STE 304, Jacksonville, FL 32207

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Other Identifiers 4

Medicaid2711478-00FL

OtherP00364691FL · Railroad Medicare

Medicare UPINH86174

Medicare PIN52104YFL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Shashi Chetan Md 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 ID9436121456

PECOS Enrollment IDI20041203000198

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.

Areas of Expertise CMS Part B claims

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.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

181 services172 patients

Hospital Affiliations CMS Care Compare

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

Ascension St Vincent's Southside

Acute Care Hospitals · Jacksonville, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100307

Location4201 Belfort RdJacksonville, FL 32216 · Duval County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32207 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.

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Other Providers at the Same Location NPPES 20

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

SANDRELA MUSSALLAM ABU SHAIBEH

Hospitalist