Individual provider Active NPI

Jonathan Ambut

  • Student in an Organized Health Care Education/Training Program
  • Charlottesville, VA
National Provider Identifier
1669036620
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1215 Lee St Box 801406
Charlottesville, VA 22908-0816
Phone
(434) 924-1825
NPI assigned
Apr 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1215 Lee St Box 801406
Charlottesville, VA 22908-0816

Mailing address

1215 Lee St Box 801406
Charlottesville, VA 22908-0816

Other practice location 1

4300 Alton Rd
Miami Beach, FL 33140-2948
Phone (305) 674-2310

Other practice location 2

4300 Alton Rd
Miami Beach, FL 33140-2948
Phone (305) 674-2310

Other practice location 3

1600 NW 10th Ave
Miami, FL 33136-1015
Phone (305) 243-3234

Other practice location 4

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-8497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250721000074 VA Order and Referring Only - EndocrinologyPractitioner - Endocrinology 2961918628

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: jambut675672@direct.healthsystem.virginia.edu

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1669036620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST BOX 801406",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST BOX 801406",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-1825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 Alton Rd",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331402948",
            "country_code": "US",
            "telephone_number": "305-674-2310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4300 Alton Rd",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331402948",
            "country_code": "US",
            "telephone_number": "305-674-2310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 NW 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361015",
            "country_code": "US",
            "telephone_number": "305-243-3234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Nicolls Rd",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117940001",
            "country_code": "US",
            "telephone_number": "631-444-8497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMBUT",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-25",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.