NPIMap

Individual provider Active NPI

Ambrose John Joseph Chazhikattu, MD

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1629206701
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME112619 Issued in FL
Practice address
608 S Tampania Ave
Tampa, FL 33609-4143
Phone
(813) 844-6770
Fax
(813) 844-6771
NPI assigned
Jun 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME112619 FL Primary

Addresses

Primary practice location

608 S Tampania Ave
Tampa, FL 33609-4143

Mailing address

508 S Habana Ave
Ste 300
Tampa, FL 33609-4144
Phone (813) 877-6770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140909000165 FL Practitioner - Internal Medicine 0446406706 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sports and Orthopedic Rehabilitation Services IncGroup PAC ID 0840104253, shared by 4 NPIs, 314 clinicians
Health Associates of Tampa Bay PAGroup PAC ID 1153580725, 3 clinicians

Practice addresses (Care Compare)

3411 S Dale Mabry Hwy
Tampa, FL 33629-8658
Phone (813) 742-9501

508 S Habana Ave
Suite 300
Tampa, FL 33609-4144
Phone (813) 877-6770

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
156694NCMDPerinatal Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Health Associates of Tampa Bay PA Internal Medicine CurrentSince Jun 1, 2014 Accepting new patients
Post Acute Specialists of Florida PLLC Internal Medicine CurrentSince Jan 22, 2024 Accepting new patients

Locations

2203 N Lois Ave
Ste 814
Tampa, FL 33607
Phone (813) 505-5060

608 S Tampania Ave
Tampa, FL 33609
Phone (813) 855-8400

508 S Habana Ave
Ste 300
Tampa, FL 33609
Phone (813) 877-6770

Interoperability endpoints

  • Direct secure messaging: ambrose.chazhikattu@355475078774788.direct.elationemr.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 10

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1629206701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 S HABANA AVE",
            "address_2": "STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094144",
            "telephone_number": "813-877-6770",
            "fax_number": "813-877-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 S TAMPANIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094143",
            "telephone_number": "813-844-6770",
            "fax_number": "813-844-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAZHIKATTU",
        "first_name": "AMBROSE JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME112619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.