Active NPI
Donald L. Ambroziak, D.P.M.
- Podiatrist
- Lexington, KY
National Provider Identifier
1952363764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 00148
- Practice address
- 141 Prosperous PL
Suite 22a
Lexington, KY 40509-1854 - Phone
- (859) 263-2230
- Fax
- (859) 263-8641
- NPI assigned
- Apr 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 00148 | KY | Primary |
Addresses
Primary practice location
141 Prosperous PL
Suite 22a
Lexington, KY 40509-1854
Mailing address
141 Prosperous PL
Suite 22a
Lexington, KY 40509-1854
Phone (859) 263-2230
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80903784 | Medicaid | KY | |
| 80001480 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 148 | KY | MD | Periodontist |
| 00148 | KY | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cumberland Foot and Ankle Centers | Past | Accepting new patients | |
| Cumberland Foot & Ankle Centers | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Foot & Ankle Surgery Podiatrist
- Somerset, KY
- NPI 1093901100
-
- Foot & Ankle Surgery Podiatrist
- Richmond, KY
- NPI 1013417419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354752000000",
"number": "1952363764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 PROSPEROUS PL",
"address_2": "SUITE 22A",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405091854",
"telephone_number": "859-263-2230",
"fax_number": "859-263-8641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 PROSPEROUS PL",
"address_2": "SUITE 22A",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405091854",
"telephone_number": "859-263-2230",
"fax_number": "859-263-8641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMBROZIAK",
"first_name": "DONALD",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-05",
"last_updated": "2012-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "KY",
"license": "00148",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80903784",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80001480",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.