Individual provider Active NPI

Ruchi Ajay Amin, M.D.

  • Pediatric Surgery Physician
  • Plantation, FL
National Provider Identifier
1114365855
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
155195 Issued in FL
Practice address
300 NW 70TH Ave Ste 202
Plantation, FL 33317-2367
Phone
(954) 584-8500
NPI assigned
Jun 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Surgery Physician 2086S0120X 155195 FL Primary

Addresses

Primary practice location

300 NW 70TH Ave Ste 202
Plantation, FL 33317-2367

Mailing address

300 NW 70TH Ave Ste 202
Plantation, FL 33317-2367
Phone (954) 584-8500

Other practice location 1

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 744-5069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160427000789 NC Order and Referring Only - General SurgeryPractitioner - General Surgery 2860791738

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
155195FLMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Pediatric Surgeons PA Pediatric Surgery PastSince Sep 11, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1114365855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 NW 70TH AVE STE 202",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172367",
            "telephone_number": "954-584-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NW 70TH AVE STE 202",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172367",
            "telephone_number": "954-584-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342818",
            "country_code": "US",
            "telephone_number": "252-744-5069",
            "fax_number": "252-744-3156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMIN",
        "first_name": "RUCHI",
        "middle_name": "AJAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-04",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "FL",
            "license": "155195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.