Individual provider Active NPI

Ralph L Aquadro III, MD

  • Plastic Surgery Physician
  • Auburn, AL
National Provider Identifier
1992835722
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
31455 Issued in AL
Practice address
1935 E. Glenn Ave.
Ste 102
Auburn, AL 36830
Phone
(334) 321-4989
Fax
(334) 501-2223
NPI assigned
Mar 7, 2007
Last updated
Jan 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 31455 AL Primary

Addresses

Primary practice location

1935 E. Glenn Ave.
Ste 102
Auburn, AL 36830

Mailing address

1935 E. Glenn Ave
Ste 102
Auburn, AL 36830
Phone (334) 321-4989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20120709000567 AL Practitioner - Plastic and Reconstructive Surgery 5395900815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of South Alabama College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1935 E Glenn Ave
Suite 102
Auburn, AL 36830-5999
Phone (334) 321-4989

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31455ALMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Alabama Plastic Surgery, LLC Single Specialty CurrentSince Mar 9, 2012 Accepting new patients

Locations

1935 E Glenn Ave
Ste 102
Auburn, AL 36830
Phone (334) 321-4989

778 N Dean Rd
Ste 400
Auburn, AL 36830
Phone (334) 321-4989

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDIIBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/JDIIBA/Endpoint/JDIIBA

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1992835722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 E. GLENN AVE",
            "address_2": "STE 102",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "36830",
            "telephone_number": "334-321-4989",
            "fax_number": "334-501-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 E. GLENN AVE.",
            "address_2": "STE 102",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "36830",
            "telephone_number": "334-321-4989",
            "fax_number": "334-501-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AQUADRO",
        "first_name": "RALPH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "AL",
            "license": "31455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, AL

Sources for this page

Verify at the official NPI Registry.