Individual provider Active NPI

Anish Y Amin, DPM

  • Podiatrist
  • Jacksonville, FL
National Provider Identifier
1265819700
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO4111 Issued in FL
Practice address
5911 Timuquana Rd Unit 300
Jacksonville, FL 32210-7897
Phone
(904) 778-3000
Fax
(904) 771-2002
NPI assigned
May 5, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO4111 FL
Podiatrist 213E00000X PO4111 FL Primary

Addresses

Primary practice location

5911 Timuquana Rd Unit 300
Jacksonville, FL 32210-7897

Mailing address

5911 Timuquana Rd Unit 300
Jacksonville, FL 32210-7897
Phone (904) 251-5053

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190815001039 FL Practitioner - Podiatry 6002125218 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Podiatry Associates of Florida IncGroup PAC ID 8820044688, 3 clinicians
Pedirite Medical FL LLCGroup PAC ID 7113336843, 14 clinicians

Practice addresses (Care Compare)

1361 13TH Ave S
Suite 120
Jacksonville Beach, FL 32250-3260
Phone (904) 251-5053

60 N Hwy 17 92
Debary, FL 32713-2513
Phone (212) 764-0008

Hospital & facility affiliations

  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue120
Removal of skin lesions18
Removal of nail tissue3128
Removal or shaving of skin growth370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1333MAMDChiropractor
PO4111FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatry Associates of Florida Inc Single Specialty CurrentSince Apr 7, 2022 Accepting new patients
Podiatry Associates of Florida, Inc. Single Specialty Current Accepting new patients
Podiatry Associates of Florida Inc Single Specialty CurrentSince Apr 7, 2022 Accepting new patients
Pedirite Medical FL LLC Single Specialty CurrentSince Jun 1, 2021 Accepting new patients
Adler Podiatry Clinic PLLC Single Specialty CurrentSince Aug 5, 2019 Accepting new patients
Podiatry Associates of Florida, Inc. Single Specialty Past Accepting new patients

Locations

60 N US Highway 17 92
Debary, FL 32713
Phone (386) 668-4426

3636 University Blvd S
Ste C
Jacksonville, FL 32216
Phone (904) 731-1711

5911 Timuquana Rd
Ste 300
Jacksonville, FL 32210

8825 Perimeter Park Blvd
Ste 202
Jacksonville, FL 32216
Phone (904) 645-6982

5911 Timuquana Rd
Unit 300
Jacksonville, FL 32210
Phone (904) 778-3000

1361 13th Ave S
Ste 120
Jax Bch, FL 32250
Phone (904) 241-2655

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIBJDD/Endpoint/GIBJDD

Organizations & group practices 6

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": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1265819700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 TIMUQUANA RD UNIT 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322107897",
            "telephone_number": "904-251-5053",
            "fax_number": "904-224-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 TIMUQUANA RD UNIT 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322107897",
            "telephone_number": "904-778-3000",
            "fax_number": "904-771-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIN",
        "first_name": "ANISH",
        "middle_name": "Y",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-05",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO4111",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO4111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.