Individual provider Active NPI

Hendrick Vega Medina, APRN

  • Family Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1013472554
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11001328 Issued in FL
Practice address
18300 NW 62ND Ave Ste 100
Hialeah, FL 33015-8207
Phone
(305) 749-6203
Fax
(786) 520-3173
NPI assigned
Feb 8, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X APRN11001328 FL Primary

Addresses

Primary practice location

18300 NW 62ND Ave Ste 100
Hialeah, FL 33015-8207

Mailing address

18300 NW 62ND Ave Ste 100
Hialeah, FL 33015-8207
Phone (305) 749-6203

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230404001508 FL Practitioner - Nurse Practitioner 8123493293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reyna Health Trust IncGroup PAC ID 5395912778, 5 clinicians

Practice addresses (Care Compare)

18300 NW 62ND Ave
Suite 100
Miami Gardens, FL 33015-8207
Phone (305) 749-6203

Hospital & facility affiliations

  • Larkin Community Hospital Palm Springs Campus Hospital, Hialeah, FL, CCN 100050
  • Hialeah Hospital Hospital, Hialeah, FL, CCN 100053
  • Palmetto General Hospital Hospital, Hialeah, FL, CCN 100187
  • Larkin Community Hospital Hospital, South Miami, FL, CCN 100181

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vega Medical Center Corp Single Specialty Current Accepting new patients
Reyna Health Trust Inc Single Specialty CurrentSince Mar 1, 2023 Accepting new patients

Locations

18300 NW 62nd Ave
Ste 100
Miami Gardens, FL 33015
Phone (305) 749-6203

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

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.

Hospital & facility affiliations 4

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": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1013472554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18300 NW 62ND AVE STE 100",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330158207",
            "telephone_number": "305-749-6203",
            "fax_number": "786-520-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 NW 62ND AVE STE 100",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330158207",
            "telephone_number": "305-749-6203",
            "fax_number": "786-520-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA MEDINA",
        "first_name": "HENDRICK",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-08",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11001328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.