Individual provider Active NPI

Amberpet Yesuraj Rathnam, MD

  • Pediatric Adolescent Medicine Physician
  • Sunrise, FL
National Provider Identifier
1194802124
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
ME90355 Issued in FL
Practice address
6765 Sunset Strip
Suite 6 & 7
Sunrise, FL 33313-2894
Phone
(954) 572-7755
Fax
(954) 572-7799
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X ME90355 FL Primary
General Practice Physician 208D00000X ME90355 FL

Addresses

Primary practice location

6765 Sunset Strip
Suite 6 & 7
Sunrise, FL 33313-2894

Mailing address

6765 Sunset Strip Ste 6
Sunrise, FL 33313-2894
Phone (954) 572-7755

Other identifiers 1

IdentifierTypeStateIssuer
271159100MedicaidFL

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
I20231129000988 FL Practitioner - Pediatric Medicine 3577918879

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME90355FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Medical and Wellness Practice LLC CurrentSince Feb 16, 2025 Accepting new patients

Locations

6765 Sunset Strip
Ste 6
Sunrise, FL 33313
Phone (954) 572-7755

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1194802124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6765 SUNSET STRIP STE 6",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333132894",
            "telephone_number": "954-572-7755",
            "fax_number": "954-572-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6765 SUNSET STRIP",
            "address_2": "SUITE 6 & 7",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333132894",
            "telephone_number": "954-572-7755",
            "fax_number": "954-572-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHNAM",
        "first_name": "AMBERPET",
        "middle_name": "YESURAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME90355",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME90355",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271159100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

Verify at the official NPI Registry.