Individual provider Active NPI

Adrian Kyle Ambrose, MD

  • Obstetrics & Gynecology Physician
  • Orlando, FL
National Provider Identifier
1770140113
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME164174 Issued in FL
Practice address
9679 Lake Nona Village PL
Orlando, FL 32827-7310
Phone
(407) 277-9242
Fax
(407) 636-7805
NPI assigned
May 21, 2019
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X FL
Obstetrics & Gynecology Physician 207V00000X ME164174 FL Primary

Addresses

Primary practice location

9679 Lake Nona Village PL
Orlando, FL 32827-7310

Mailing address

9679 Lake Nona Village PL
Orlando, FL 32827-7310
Phone (407) 277-9242

Other practice location 1

1401 Lucerne Ter # Mp818
Orlando, FL 32806-2001
Phone (321) 841-5297

Other identifiers 1

IdentifierTypeStateIssuer
119191900MedicaidFL

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
I20230815000947 FL Practitioner - Obstetrics/Gynecology 9830551464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

9679 Lake Nona Village PL
Suite 101
Orlando, FL 32827-7310
Phone (407) 277-9242

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Aug 10, 2023 Accepting new patients
Orlando Health Medical Group Inc Obstetrics & Gynecology CurrentSince Aug 10, 2023 Accepting new patients
Physician Associates LLC PastSince Aug 27, 2023 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

9679 Lake Nona Village Pl
Ste 101
Orlando, FL 32827
Phone (407) 261-2934

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1770140113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9679 LAKE NONA VILLAGE PL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277310",
            "telephone_number": "407-277-9242",
            "fax_number": "407-636-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9679 LAKE NONA VILLAGE PL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277310",
            "telephone_number": "407-277-9242",
            "fax_number": "407-636-7805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Lucerne Ter # Mp818",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328062001",
            "country_code": "US",
            "telephone_number": "321-841-5297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "ADRIAN",
        "middle_name": "KYLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-21",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME164174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119191900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.