Organization Active NPI

Jorge M Barcenas MD PA

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1023291002
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
43880 Issued in FL
Legal business name
JORGE M BARCENAS MD PA
Practice address
14687 SW 104TH St
Miami, FL 33186-2977
Phone
(305) 383-3372
Fax
(305) 387-7366
NPI assigned
Dec 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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

Authorized official

Name
Dr. Jorge M Barcenas, MDNPI 1790797074
Title
President
Phone
(305) 383-3372

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 43880 FL Primary

Addresses

Primary practice location

14687 SW 104TH St
Miami, FL 33186-2977

Mailing address

14687 SW 104TH St
Miami, FL 33186-2977
Phone (305) 383-3372

Other identifiers 2

IdentifierTypeStateIssuer
001944800OtherFLMEDICAID GROUP #001944800
042122700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040617000370 FL Part B Supplier - Clinic/Group Practice 9638153513 Receives reassigned benefits from 4 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

14687 SW 104th St
Miami, FL 33186
Phone (305) 383-3372

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418688000000",
    "number": "1023291002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14687 SW 104TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862977",
            "telephone_number": "305-383-3372",
            "fax_number": "305-387-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14687 SW 104TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862977",
            "telephone_number": "305-383-3372",
            "fax_number": "305-387-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORGE M BARCENAS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-12",
        "last_updated": "2014-12-16",
        "status": "A",
        "authorized_official_last_name": "BARCENAS",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-383-3372",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "43880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP #001944800",
            "identifier": "001944800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042122700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.