Individual provider Active NPI

Eduardo Ajuria, MD

  • Pediatrics Physician
  • Doral, FL
National Provider Identifier
1598185217
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME138115 Issued in FL
Practice address
9655 NW 41St St
Doral, FL 33178-2973
Phone
(305) 436-1563
Fax
(305) 436-1564
NPI assigned
Apr 21, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A129412 CA
Pediatrics Physician 208000000X ME138115 FL Primary

Addresses

Primary practice location

9655 NW 41St St
Doral, FL 33178-2973

Mailing address

3470 E Coast Ave Apt H1511
Miami, FL 33137-3992
Phone (909) 518-0726

Other identifiers 1

IdentifierTypeStateIssuer
101136900MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230620002240 CA Practitioner - Pediatric Medicine 3274841358 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129412CAMDSocial Worker
ME138115FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince May 16, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics Past Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson, LLC Pediatrics Past Accepting new patients

Locations

3733 San Dimas St
Bakersfield, CA 93301
Phone (661) 631-3008

3733 San Dimas St
Ste 101
Bakersfield, CA 93301
Phone (800) 353-5400

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": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1598185217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3470 E COAST AVE APT H1511",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331373992",
            "telephone_number": "909-518-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9655 NW 41ST ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782973",
            "telephone_number": "305-436-1563",
            "fax_number": "305-436-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJURIA",
        "first_name": "EDUARDO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-21",
        "last_updated": "2023-09-26",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A129412",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME138115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101136900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3733 San Dimas St",
            "city": "Bakersfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "933011407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.