Individual provider Active NPI

Ambreen Fatima Tariq, M.D.

  • Internal Medicine Physician
  • Boynton Beach, FL
National Provider Identifier
1932549383
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME130639 Issued in FL
Practice address
10301 Hagen Ranch Rd Ste B6
Boynton Beach, FL 33437-3723
Phone
(561) 752-9490
Fax
(561) 752-9491
NPI assigned
Jun 30, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X FR0435669141 NY
Internal Medicine Physician 207R00000X ME130639 FL Primary

Addresses

Primary practice location

10301 Hagen Ranch Rd Ste B6
Boynton Beach, FL 33437-3723

Mailing address

1065 NE 125TH St Ste 409
North Miami, FL 33161-5834
Phone (888) 852-6672

Other identifiers 1

IdentifierTypeStateIssuer
ME130693OtherFLLICENSE

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
I20180202002271 FL Practitioner - General PracticePractitioner - Internal Medicine 2264792670 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME130639FLMDInternal Medicine Physician
FR0435669141NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary & Internal Medicine Associates Inc Internal Medicine CurrentSince Jun 1, 2018 Accepting new patients
MD Now Medical Centers Inc CurrentSince Dec 5, 2017 Accepting new patients
MD Now Medical Centers Inc CurrentSince Dec 5, 2017 Accepting new patients
Associates of Pulmonary Medicine LLC CurrentSince Apr 5, 2020 Accepting new patients

Locations

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

1770 NE Miami Gardens Dr
North Miami Beach, FL 33179
Phone (305) 949-4141

2221 SE Ocean Blvd
Ste 100
Stuart, FL 34996
Phone (561) 283-4428

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1372550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1932549383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 NE 125TH ST STE 409",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615834",
            "telephone_number": "888-852-6672",
            "fax_number": "786-235-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 HAGEN RANCH RD STE B6",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373723",
            "telephone_number": "561-752-9490",
            "fax_number": "561-752-9491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARIQ",
        "first_name": "AMBREEN",
        "middle_name": "FATIMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "FR0435669141",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME130639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ME130693",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.