Individual provider Active NPI

Leyany Mayo Gonzalez

  • Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1023856887
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11033974 Issued in FL
Practice address
737 E 10TH St
Hialeah, FL 33010-3635
Phone
(786) 590-0659
NPI assigned
Jul 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11033974 FL Primary

Addresses

Primary practice location

737 E 10TH St
Hialeah, FL 33010-3635

Mailing address

737 E 10TH St
Hialeah, FL 33010-3635
Phone (786) 590-0659

Other practice location 1

11034 SW 16th Manor
Davie, FL 33324
Phone (786) 362-0867

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
I20241001004302 FL Practitioner - Nurse Practitioner 8527599539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Grove Physician Services PAGroup PAC ID 8628421526, 65 clinicians

Practice addresses (Care Compare)

160 NW 170 St
North Miami Beach, FL 33169-5521
Phone (305) 651-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11033974FLMDNurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1023856887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 E 10TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330103635",
            "telephone_number": "786-590-0659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 E 10TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330103635",
            "telephone_number": "786-590-0659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11034 SW 16th Manor",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "33324",
            "country_code": "US",
            "telephone_number": "786-362-0867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYO GONZALEZ",
        "first_name": "LEYANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11033974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.