Ralph L Aquadro III, MD

Individual provider Active NPI Plastic Surgery Physician · Auburn, AL

NPI 1992835722 · NPPES record last updated Jan 26, 2018

Key facts

NPI
1992835722
Entity type
Individual (NPI type 1)
Primary specialty
Plastic Surgery Physician 208200000X
License
31455 (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
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

Medicare Care Compare profile

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

  • The East Alabama Healthcare Authority Hospital · Opelika, AL · CCN 010029

Procedures performed for Medicare patients

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120709000567 AL Practitioner - Plastic and Reconstructive Surgery 5395900815 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31455ALMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Alabama Plastic Surgery, LLC Single Specialty Current
since 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/Endpoint/JDIIBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/JDIIBA

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208200000X 31455 AL Yes

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

Other providers in Auburn, AL

All providers in Auburn, AL · Plastic Surgery Physician in Alabama

Sources for this page

Verify at the official NPI Registry.