Individual provider Active NPI

Ney F Andujar, MD

  • Specialist
National Provider Identifier
1033146303
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME80487 Issued in FL
Practice address
1401 SE Goldtree Drive, Ste 104
Port St Lucie, FL 34952
UM
Phone
(772) 905-8531
Fax
(772) 905-8526
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME80487 FL Primary

Addresses

Primary practice location

1401 SE Goldtree Drive, Ste 104
Port St Lucie, FL 34952
UM

Mailing address

1401 SE Goldtree Dr Ste 104
Port St Lucie, FL 34952-7584
Phone (772) 905-8531

Other identifiers 1

IdentifierTypeStateIssuer
265334600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050503000377 FL Practitioner - Psychiatry 7416996053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1401 SE Goldtree Dr
Suite 104
Port St Lucie, FL 34952-7584
Phone (772) 905-8531

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME80487FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Ney F Andujar, M.D. PA Specialist CurrentSince Apr 15, 2005 Accepting new patients
Lawnwood Pavilion Physician Services LLC Past Accepting new patients
Liana Urfer, MD, PA Past Accepting new patients

Locations

1401 SE Goldtree Dr
Ste 104
Port St Lucie, FL 34952
Phone (772) 905-0531

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1033146303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SE GOLDTREE DR STE 104",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527584",
            "telephone_number": "772-905-8531",
            "fax_number": "772-905-8526"
        },
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "1401 SE GOLDTREE DRIVE, STE 104",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "34952",
            "telephone_number": "772-905-8531",
            "fax_number": "772-905-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDUJAR",
        "first_name": "NEY",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME80487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265334600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.