Individual provider Active NPI

Patricia Louise Ambrosio, D.O.

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1316353667
Registry record updated Apr 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS12838 Issued in FL
Practice address
5900 S John Young Pkwy
Orlando, FL 32839-3716
Phone
(407) 398-6470
Fax
(407) 894-6872
NPI assigned
Jul 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OS12838 FL Primary

Addresses

Primary practice location

5900 S John Young Pkwy
Orlando, FL 32839-3716

Mailing address

5900 S John Young Pkwy
Orlando, FL 32839-3716
Phone (407) 398-6470

Other identifiers 1

IdentifierTypeStateIssuer
015030100MedicaidFL

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
I20170608001878 FL Practitioner - Pediatric Medicine 0941428619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.2 of 100Reported as group
Quality
78.64
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS12838FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Mar 26, 2017 Accepting new patients
The Nemours Foundation CurrentSince Mar 26, 2017 Accepting new patients
Emergency Physicians of Central Florida LLP CurrentSince Jun 1, 2017 Accepting new patients

Locations

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

575 W State Road 434
Longwood, FL 32750
Phone (321) 841-4514

92 W Miller St
Orlando, FL 32806
Phone (321) 841-4607

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

1414 S Orange Ave
#112
Orlando, FL 32806
Phone (407) 767-1200

Organizations & group practices 4

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": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586476800000",
    "number": "1316353667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 S JOHN YOUNG PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328393716",
            "telephone_number": "407-398-6470",
            "fax_number": "407-894-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 S JOHN YOUNG PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328393716",
            "telephone_number": "407-398-6470",
            "fax_number": "407-894-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSIO",
        "first_name": "PATRICIA",
        "middle_name": "LOUISE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS12838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015030100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.