NPIMap

Individual provider Active NPI

Aijan T. Ukudeeva, M.D.

  • Anatomic Pathology Physician
  • Tampa, FL
National Provider Identifier
1477966992
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
BP20060926 Issued in TX
Practice address
5481 W Waters Ave
Suite 111
Tampa, FL 33634
Phone
(305) 585-8381
NPI assigned
Jun 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X BP20060926 TX Primary
Anatomic Pathology Physician 207ZP0101X 36242 WV

Addresses

Primary practice location

5481 W Waters Ave
Suite 111
Tampa, FL 33634

Mailing address

1611 NW 12TH Ave Ste 2044
Miami, FL 33136-1005
Phone (305) 585-8381

Other practice location 1

1400 Hospital Dr
Hurricane, WV 25526-9202
Phone (304) 757-1700

Other practice location 2

3200 MacCorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432

Other practice location 3

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Other practice location 4

800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone (304) 388-5432

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aijan.ukudeeva@camc.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250716000250 FL Practitioner - Pathology 9830604057 Reassigns benefits to 1 organization
I20260325003399 WV Practitioner - Pathology 9830604057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3200 Maccorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP20060926TXMDAnatomic Pathology Physician
36242WVMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Woman Care, LLC CurrentSince Jun 30, 2025 Accepting new patients

Locations

2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233

1611 NW 12th Ave
Ste 2044
Miami, FL 33136
Phone (305) 243-5779

3000 Hunters Creek Blvd
Orlando, FL 32837
Phone (407) 337-8814

5481 W Waters Ave
Ste 111
Tampa, FL 33634
Phone (813) 577-4686

Interoperability endpoints

  • Direct secure messaging: aijan.ukudeeva@camc.cernerdirect.com

Organizations & group practices 2

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 11

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": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1477966992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE STE 2044",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5481 W WATERS AVE",
            "address_2": "SUITE 111",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33634",
            "telephone_number": "305-585-8381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Hurricane",
            "state": "WV",
            "postal_code": "255269202",
            "country_code": "US",
            "telephone_number": "304-757-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041227",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Morris St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011326",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253023351",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UKUDEEVA",
        "first_name": "AIJAN",
        "middle_name": "T.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "TX",
            "license": "BP20060926",
            "primary": true
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "WV",
            "license": "36242",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aijan.ukudeeva@camc.cernerdirect.com",
            "affiliation": "N",
            "address_1": "3200 MacCorkle Ave SE",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253041227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.