Individual provider Active NPI

Timothy Ramos, PA

  • Physician Assistant
  • Stuart, FL
National Provider Identifier
1174809594
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110352 Issued in FL
Practice address
2392 SE Ocean Blvd
Stuart, FL 34996-3310
Phone
(772) 223-4879
Fax
(772) 223-2847
NPI assigned
Oct 31, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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 PA9110352 FL Primary

Addresses

Primary practice location

2392 SE Ocean Blvd
Stuart, FL 34996-3310

Mailing address

PO Box 417
Stuart, FL 34995-0417
Phone (772) 223-4879

Other practice location 1

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-5440

Other identifiers 2

IdentifierTypeStateIssuer
023681600MedicaidFL
G9TTVOtherFLFLORIDA BLUE

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
I20180328002822 FL Practitioner - Physician Assistant 6103091566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Invision Health Florida, LLCGroup PAC ID 5698162642, 33 clinicians

Practice addresses (Care Compare)

901 45TH St
Mangonia Park, FL 33407-2413
Phone (561) 800-4111

Hospital & facility affiliations

  • Good Samaritan Medical Center Hospital, West Palm Beach, FL, CCN 100287

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9110352FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc CurrentSince Jun 24, 2020 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Jun 24, 2020 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

Organizations & group practices 5

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": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1174809594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349950417",
            "telephone_number": "772-223-4879",
            "fax_number": "772-223-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2392 SE OCEAN BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349963310",
            "telephone_number": "772-223-4879",
            "fax_number": "772-223-2847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-5440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-31",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023681600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "G9TTV",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.