Individual provider Active NPI

Ryan S. Jawitz, D.O.

  • Dermatology Physician
  • North Port, FL
National Provider Identifier
1659513729
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
OS11606 Issued in FL
Practice address
14840 Tamiami TRL
North Port, FL 34287-2701
Phone
(941) 538-7324
Fax
(941) 564-4080
NPI assigned
Apr 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X OS11606 FL Primary

Addresses

Primary practice location

14840 Tamiami TRL
North Port, FL 34287-2701

Mailing address

900 Village Square Xing Ste 290
Palm Beach Gardens, FL 33410-4552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120627000591 FL Practitioner - Dermatology 1951566892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

1015 Crosspointe Dr
Naples, FL 34110-0949
Phone (239) 596-9075

1295 Jacaranda Blvd
Venice, FL 34292-4522
Phone (941) 484-1510

2481 Bobcat Village Ctr Rd
Unit 101
North Port, FL 34288-8493
Phone (941) 955-0360

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision204
Removal of skin lesions503
Removal of skin cancer1425
Removal or shaving of skin growth205
Skin biopsy136

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS11606FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince Aug 1, 2012 Accepting new patients
Aqua Dermatology of Florida, PA Dermatology CurrentSince Aug 1, 2012 Accepting new patients

Locations

1012 N Mills Ave
Arcadia, FL 34266
Phone (863) 494-2663

406 N Indiana Ave
Englewood, FL 34223
Phone (941) 474-5538

15051 S Tamiami Trl
Ste 203
Fort Myers, FL 33908
Phone (239) 732-5959

8340 Lakewood Ranch Blvd
Ste 260
Lakewood Ranch, FL 34202
Phone (941) 218-1711

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

14840 Tamiami Trl
North Port, FL 34287
Phone (941) 564-1542

2481 Bobcat Village Center Rd
Unit 101
North Port, FL 34288
Phone (941) 538-7319

2426 S Tamiami Trl
Sarasota, FL 34239
Phone (507) 398-2753

1295 Jacaranda Blvd
Venice, FL 34292
Phone (941) 484-1510

900 Village Square Xing
Ste 290
West Palm Beach, FL 33410
Phone (239) 313-2517

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: rjawitz@aquadermatology.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1659513729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 VILLAGE SQUARE XING STE 290",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14840 TAMIAMI TRL",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342872701",
            "telephone_number": "941-538-7324",
            "fax_number": "941-564-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAWITZ",
        "first_name": "RYAN",
        "middle_name": "S.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-03",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS11606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Port, FL

Sources for this page

Verify at the official NPI Registry.