Individual provider Active NPI

Priya M Amin, D.C.

  • Chiropractor
  • Lutz, FL
National Provider Identifier
1033576012
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 11763 Issued in FL
Practice address
18942 N Dale Mabry Hwy
#102
Lutz, FL 33548-4907
Phone
(813) 909-0961
NPI assigned
Jan 22, 2016
Last updated
Jan 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 11763 FL Primary

Addresses

Primary practice location

18942 N Dale Mabry Hwy
#102
Lutz, FL 33548-4907

Mailing address

10331 Carroll Cove PL
Tampa, FL 33612-6508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160219002064 FL Practitioner - Chiropractic 1951606417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back in Health Wellness Center LLCGroup PAC ID 8123118049, 2 clinicians

Practice addresses (Care Compare)

18942 N Dale Mabry Hwy
Suite 102
Lutz, FL 33548-4907
Phone (813) 909-0961

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 11763FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back in Health Wellness Center LLC Chiropractor CurrentSince Jan 22, 2016 Accepting new patients

Locations

18942 N Dale Mabry Hwy
Ste 102
Lutz, FL 33548
Phone (813) 909-0961

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1033576012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10331 CARROLL COVE PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336126508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18942 N DALE MABRY HWY",
            "address_2": "#102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484907",
            "telephone_number": "813-909-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIN",
        "first_name": "PRIYA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-22",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 11763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.