Individual provider Active NPI

Niti A Amin, PA-C

  • Physician Assistant
  • Zephyrhills, FL
National Provider Identifier
1114356573
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108030 Issued in FL
Practice address
6719 Gall Blvd Ste 106
Zephyrhills, FL 33542-2568
Phone
(866) 400-3376
Fax
(866) 400-3376
NPI assigned
Nov 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9108030 FL Primary

Addresses

Primary practice location

6719 Gall Blvd Ste 106
Zephyrhills, FL 33542-2568

Mailing address

151 Southhall LN Ste 300
Maitland, FL 32751-7172
Phone (866) 400-3376

Other identifiers 1

IdentifierTypeStateIssuer
110703200MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150623002973 FL Practitioner - Physician Assistant 0547571127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leavitt Medical Associates of Florida IncGroup PAC ID 4688579311, 199 clinicians

Practice addresses (Care Compare)

1503 Buenos Aires Blvd
Suite 100
The Villages, FL 32159-6825
Phone (352) 753-2812

27612 Cashford Cir
Suite 102
Wesley Chapel, FL 33544-6954
Phone (813) 991-1457

6719 Gall Blvd
Suite 106
Zephyrhills, FL 33542-2568
Phone (813) 355-5870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9108030FLMDPhysician Assistant

Practice roles (4 of 6)

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc CurrentSince Mar 1, 2022 Accepting new patients
Leavitt Medical Associates of Florida Inc CurrentSince Mar 1, 2022 Accepting new patients
Leavitt Medical Associates of Florida Inc Past Accepting new patients
Total Vein and Skin LLC Past Accepting new patients

Locations

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

14521 University Point Pl
Tampa, FL 33613
Phone (813) 977-3600

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

6719 Gall Blvd
Ste 106
Zephyrhills, FL 33542
Phone (813) 355-5870

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1114356573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "866-400-3376",
            "fax_number": "407-650-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6719 GALL BLVD STE 106",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335422568",
            "telephone_number": "866-400-3376",
            "fax_number": "866-400-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIN",
        "first_name": "NITI",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-06",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110703200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.