Individual provider Active NPI

Ryan M Ilgenfritz, M.D.

  • Pediatric Orthopaedic Surgery Physician
  • Orlando, FL
National Provider Identifier
1093923450
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
ME119700 Issued in FL
Practice address
13535 Nemours Pkwy
Orlando, FL 32827-7402
Phone
(407) 567-4000
Fax
(302) 651-4945
NPI assigned
May 18, 2007
Last updated
Feb 24, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X ME119700 FL Primary

Addresses

Primary practice location

13535 Nemours Pkwy
Orlando, FL 32827-7402

Mailing address

PO Box 191
Rockland, DE 19732-0191
Phone (302) 651-4000

Other identifiers 1

IdentifierTypeStateIssuer
013636800MedicaidFL

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
I20141220000055 FL Practitioner - Orthopedic Surgery 8729256649 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME119700FLMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Jan 1, 2015 Accepting new patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Jan 1, 2015 Accepting new patients

Locations

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

1717 S Orange Ave
Ste 100
Orlando, FL 32806

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

Interoperability endpoints

  • Direct secure messaging: riigenfritz51180@direct.nemours.org

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, 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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1093923450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-4000",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13535 NEMOURS PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277402",
            "telephone_number": "407-567-4000",
            "fax_number": "302-651-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILGENFRITZ",
        "first_name": "RYAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "FL",
            "license": "ME119700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013636800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.