Individual provider Active NPI

Jagruti Amin, M.D.

  • Child & Adolescent Psychiatry Physician
  • Ambler, PA
National Provider Identifier
1306945852
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD054746L Issued in PA
Practice address
722 E Butler Pike
Ambler, PA 19002-2310
Phone
(610) 524-1552
Fax
(610) 524-6039
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

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
Child & Adolescent Psychiatry Physician 2084P0804X MD054746L PA Primary

Addresses

Primary practice location

722 E Butler Pike
Ambler, PA 19002-2310

Mailing address

722 E Butler Pike
Ambler, PA 19002-2310
Phone (610) 524-1552

Other identifiers 2

IdentifierTypeStateIssuer
0016556970003MedicaidPA
830401OtherPABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20041025000327 PA Practitioner - Psychiatry 1456312370 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Pennsylvania Physician Alliance, LLCGroup PAC ID 8325478662, 112 clinicians

Practice addresses (Care Compare)

4641 Roosevelt Blvd
Philadelphia, PA 19124-2343
Phone (215) 831-4600

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
78.42
Improvement activities
40
Cost
70.24

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Pennsylvania Physician Alliance LLC Child & Adolescent Psychiatry CurrentSince Jun 1, 2020 Accepting new patients
Uhs of Pennsylvania Inc CurrentSince Apr 27, 2011 Accepting new patients
Uhs of Pennsylvania Inc Current Accepting new patients

Locations

800 Park Way
Ste A
Broomall, PA 19008
Phone (215) 718-4350

2 Hospital Dr
Clarion, PA 16214
Phone (800) 253-4906

722 E Butler Pike
Maple Glen, PA 19002
Phone (215) 643-7800

4641 E Roosevelt Blvd
Philadelphia, PA 19124
Phone (215) 831-4600

Organizations & group practices 3

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306945852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 E BUTLER PIKE",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190022310",
            "telephone_number": "610-524-1552",
            "fax_number": "610-524-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 E BUTLER PIKE",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190022310",
            "telephone_number": "610-524-1552",
            "fax_number": "610-524-6039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIN",
        "first_name": "JAGRUTI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD054746L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016556970003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "830401",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ambler, PA

Sources for this page

Verify at the official NPI Registry.