Organization Active NPI

Ambareen PA

Doing business as Ambareen Internal Medicine

  • Internal Medicine Physician
  • Gainesville, FL
National Provider Identifier
1457884397
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 97329 Issued in FL
Legal business name
AMBAREEN PA
Doing business as
Ambareen Internal Medicine
Practice address
7109 NW 11TH PL
Gainesville, FL 32605-3170
Phone
(352) 331-2890
Fax
(352) 331-2915
NPI assigned
Apr 7, 2017
Last updated
Apr 7, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Authorized official

Name
Dr. Farrukh Ambareen, MDNPI 1063404457
Title
President
Phone
(352) 331-2890

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 97329 FL Primary

Addresses

Primary practice location

7109 NW 11TH PL
Gainesville, FL 32605-3170

Mailing address

7109 NW 11TH PL
Gainesville, FL 32605-3170
Phone (352) 331-2890

Other names 1

  • Ambareen Internal Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170526001982 FL Part B Supplier - Clinic/Group Practice 5799052593 Receives reassigned benefits from 1 practitioner
Practice locations: Gainesville, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2131420Ambareen, PA7109 NW 11TH PL Ste a, Gainesville, FL 32605Certificate of waiverMay 29, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491523200000",
    "number": "1457884397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7109 NW 11TH PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326053170",
            "telephone_number": "352-331-2890",
            "fax_number": "352-331-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7109 NW 11TH PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326053170",
            "telephone_number": "352-331-2890",
            "fax_number": "352-331-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBAREEN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-07",
        "last_updated": "2017-04-07",
        "status": "A",
        "authorized_official_last_name": "AMBAREEN",
        "authorized_official_first_name": "FARRUKH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-331-2890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 97329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ambareen Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.