NPIMap

Individual provider Active NPI

Ryan Martin Severdija, MD

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1801538079
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME174670 Issued in FL
Practice address
1611 NW 12TH Ave # C600D
Miami, FL 33136-1096
Phone
(305) 585-5215
NPI assigned
Apr 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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
Internal Medicine Physician 207R00000X ME174670 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave # C600D
Miami, FL 33136-1096

Mailing address

14022 SW 38TH Ter
Miami, FL 33175-6419
Phone (305) 323-0126

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
I20250721002242 FL Practitioner - Internal Medicine 2264948918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Miami, LM Miller School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 243-3100

Hospital & facility affiliations

  • Jackson Health System Hospital, Miami, FL, CCN 100022
  • Univ of Miami Hospital and Clinics-Sylvester Compr Hospital, Miami, FL, CCN 100079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME174670FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Internal Medicine CurrentSince Jun 6, 2025 Accepting new patients
University of Miami Current Accepting new patients
University of Miami Internal Medicine CurrentSince Jun 6, 2025 Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
#C600D
Miami, FL 33136
Phone (305) 585-4310

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

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 and National Provider Directory roles.

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1801538079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14022 SW 38TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331756419",
            "telephone_number": "305-323-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE # C600D",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361096",
            "telephone_number": "305-585-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERDIJA",
        "first_name": "RYAN",
        "middle_name": "MARTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-08",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME174670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.