Active NPI
Joseph Albert Ninke, MD
- Otolaryngology Physician
- Lakeland, FL
National Provider Identifier
1962491167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- ME85949
- Practice address
- 1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543 - Phone
- (863) 687-1321
- Fax
- (863) 284-1730
- NPI assigned
- Oct 19, 2005
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 207YX0007X | 84424 | GA | |
| Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 207YX0007X | ME85949 | FL | |
| Otolaryngology Physician | 207Y00000X | ME85949 | FL | Primary |
Addresses
Primary practice location
1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Mailing address
1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-3294
Other practice location 1
7915 Bay St
Sebastian, FL 32958-4005
Phone (772) 581-3687
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962491167 | Other | FL | NPI |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Regional Health Systems, Inc. | Multi-Specialty | Current | Accepting new patients |
| Gwinnett Medical Group, Inc | Multi-Specialty | Past | Accepting new patients |
Locations
3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565
1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132
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.
-
- Multi-Specialty Clinic/Center
- Lakeland, FL
- NPI 1497748743
-
- General Practice Physician
- Lawrenceville, GA
- NPI 1780747469
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1962491167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 MEDICAL CENTER BLVD",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300467694",
"telephone_number": "678-312-3294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1324 LAKELAND HILLS BLVD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338054543",
"telephone_number": "863-687-1321",
"fax_number": "863-284-1730"
}
],
"practiceLocations": [
{
"address_1": "7915 Bay St",
"address_purpose": "LOCATION",
"city": "Sebastian",
"state": "FL",
"postal_code": "329584005",
"country_code": "US",
"telephone_number": "772-581-3687",
"fax_number": "772-581-3680",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NINKE",
"first_name": "JOSEPH",
"middle_name": "ALBERT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-19",
"last_updated": "2020-11-04",
"certification_date": "2020-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0007X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
"state": "GA",
"license": "84424",
"primary": false
},
{
"code": "207YX0007X",
"taxonomy_group": "",
"desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
"state": "FL",
"license": "ME85949",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "FL",
"license": "ME85949",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1962491167",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.