Amirtha Ajit, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A56179 Issued in CA

Practice address

1751 W Romneya Dr
Anaheim, CA 92801-1815

Phone

(714) 776-3180

Fax

(714) 991-1932

NPI assigned

Sep 9, 2005

Last updated

Oct 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Shirdi Medical Corporation

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1023003001
  Authorized official Same address or phone
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  NPD (past)

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1881688422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 W ROMNEYA DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011815",
            "telephone_number": "714-776-3180",
            "fax_number": "714-991-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 W ROMNEYA DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011815",
            "telephone_number": "714-776-3180",
            "fax_number": "714-991-1932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "947 S Anaheim Blvd Ste 125",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928055584",
            "country_code": "US",
            "telephone_number": "714-776-3180",
            "fax_number": "714-991-1932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AJIT",
        "first_name": "AMIRTHA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A56179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A561790",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aajit1374301@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "947 S Anaheim Blvd Ste 125",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928055584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Internal Medicine Physician in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.