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Public Health Trust of Miami Dade County Florida

Organization Active NPI Hospitalist Physician · Miami, FL

NPI 1043395460 · NPPES record last updated Jun 18, 2021

Key facts

NPI
1043395460
Entity type
Organization (NPI type 2)
Primary specialty
Hospitalist Physician 208M00000X
Legal business name
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1005
Phone
(305) 585-8957
Fax
(305) 585-5259
NPI assigned
Oct 25, 2006
Organization subpart
Yes
Parent organization (as reported)
PHT OF DADE COUNTY

Authorized official

Name
Mr. Mark T Knight
Title
Executive VP, Cfo
Phone
(305) 585-7137

Owned or controlled facilities with NPI records 25

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 14

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 149

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

View all 149

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Public Health Trust of Miami Dade County Florida
Miami, FL · CCN 100022		 Hospital Operational/Managerial Control (100%) Oct 1, 1973
Jackson Memorial Long Term Care Center
Miami, FL · CCN 105392		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Adp of the SNF		 Apr 25, 1992
Apr 25, 1992
May 5, 2025
Public Health Trust of Miami Dade County Florida
Cutler Bay, FL · CCN 105252		 Skilled nursing facility 5% Or Greater Direct Ownership Interest
Operational/Managerial Control
Adp of the SNF		 Oct 1, 1973
Oct 1, 1973
Oct 1, 1973

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031117000037 FL Part B Supplier - Clinic/Group Practice 8628981925 Receives reassigned benefits from 94 practitioners
16 other NPIs on this enrollment
Practice locations: Miami, FL

National Provider Directory

Tax ID family
Dianne M Parker MD (54 organizations share this tax ID)
Part of
Dianne M Parker MD

Locations

1500 NW 12th Ave
Ste 1129
Miami, FL 33136
Phone (305) 585-8957

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 208M00000X Yes

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1005

Mailing address

1500 NW 12TH Ave
Jackson Medical Towers Suite 1129
Miami, FL 33136-1051
Phone (305) 585-8957

Other identifiers

IdentifierTypeStateIssuer
272051500MedicaidFL

Other names

  • PHT/JHS-JMH Hospitalists Doing business as

Other providers in Miami, FL

All providers in Miami, FL · Hospitalist Physician in Florida

Sources for this page

Verify at the official NPI Registry.