Ellen Dzierzak Tamboli
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Miami, FL
NPI 1629607494 · NPPES record last updated Feb 16, 2026
Key facts
- NPI
- 1629607494
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- OS22429 (FL)
- Practice address
- 1611 NW 12TH Ave
Miami, FL 33136-1005 - Phone
- (305) 243-6605
- Fax
- (305) 243-4650
- NPI assigned
- Apr 3, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 24
Medicare Care Compare profile
- Specialty
- Physical Medicine and Rehabilitation
- Education
- Nova Southeastern College of Osteo Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- University of Miami
Practice addresses (Care Compare)
1120 NW 14TH St
Miami, FL 33136-2107
Phone (305) 689-8648
Hospital & facility affiliations
- Jackson Health System
- Univ of Miami Hospital and Clinics-Sylvester Compr
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260213001977 | FL | Practitioner - Physical Medicine and Rehabilitation | 5294166823 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS22429 | FL | MD | Physical Medicine & Rehabilitation Physician |
| 22429 | FL | MD | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
Practice roles (4 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Miami | Current |
Accepting new patients | |
| University of Miami | Physical Medicine & Rehabilitation | Current |
Accepting new patients |
| University of Miami | Past | Accepting new patients | |
| Centracare Clinic | Past | Accepting new patients |
Locations
4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000
1120 NW 14th St
Miami, FL 33136
Phone (305) 243-2000
1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226
1120 NW 14th St
Ste 101
Miami, FL 33136
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 2081P2900X | 22429 | FL | |
| Physical Medicine & Rehabilitation Physician | 208100000X | OS22429 | FL | Yes |
Addresses
Primary practice location
1611 NW 12TH Ave
Miami, FL 33136-1005
Mailing address
1611 NW 12TH Ave
Miami, FL 33136-1005
Phone (305) 243-6605
Other providers in Miami, FL
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- Raymundo Tamayo
- Richard A Tamayo
- Veronica Margarita Tamayo
- Yenisley Tamayo
- Mohammad A Tamer
- Tamiami a.L.F. Corp
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- Tamiami Community Center LLC
All providers in Miami, FL · Physical Medicine & Rehabilitation Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.