Individual provider Active NPI

Victor H Ayala, M.D.

  • Internal Medicine Physician
  • Plantation, FL
National Provider Identifier
1215027222
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 0055215 Issued in FL
Practice address
220 SW 84TH Ave
Suite 106
Plantation, FL 33324-2754
Phone
(954) 452-0774
Fax
(954) 424-8023
NPI assigned
Oct 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 0055215 FL Primary

Addresses

Primary practice location

220 SW 84TH Ave
Suite 106
Plantation, FL 33324-2754

Mailing address

220 SW 84TH Ave
Suite 106
Plantation, FL 33324-2754
Phone (954) 452-0774

Other identifiers 5

IdentifierTypeStateIssuer
09304OtherFLBCBS PROVIDER NUMBER
650219708OtherFLHUMANA PROVIDER NUMBER
100040OtherFLAVMED PROVIDER NUMBER
2011773OtherFLAETNA PROVIDER NUMBER
0402460OtherFLUNITEDHEALTHCARE PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 0055215FLMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: ayala.victor.1@14802.direct.athenahealth.com

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, 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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215027222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SW 84TH AVE",
            "address_2": "SUITE 106",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242754",
            "telephone_number": "954-452-0774",
            "fax_number": "954-424-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SW 84TH AVE",
            "address_2": "SUITE 106",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242754",
            "telephone_number": "954-452-0774",
            "fax_number": "954-424-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYALA",
        "first_name": "VICTOR",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 0055215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "09304",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA PROVIDER NUMBER",
            "identifier": "650219708",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED PROVIDER NUMBER",
            "identifier": "100040",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "2011773",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE PROVIDER",
            "identifier": "0402460",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.