Individual provider Active NPI

Alexander Boepple Su

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1043604069
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME131452 Issued in FL
Practice address
1611 NW 12TH Ave
Miami, FL 33136
Phone
(305) 243-2951
NPI assigned
Mar 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME131452 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136

Mailing address

1611 NW 12TH Ave
Miami, FL 33136-1005

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190218003017 FL Practitioner - Family Practice 0446598361 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13120 Biscayne Blvd
North Miami, FL 33181-2013
Phone (305) 585-9210

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
78.79
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME131452FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida Current Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Aug 18, 2018 Accepting new patients
University of Miami CurrentSince Nov 23, 2022 Accepting new patients
University of Miami Family Medicine CurrentSince Nov 23, 2022 Accepting new patients
University of Miami Current Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Aug 18, 2018 Accepting new patients

Locations

18910 S Dixie Hwy
Cutler Bay, FL 33157
Phone (305) 585-9230

7400 NW 104th Ave
Unit D103
Doral, FL 33178

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

8932 SW 97th Ave
Miami, FL 33176
Phone (305) 270-3485

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1475 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4200

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

13120 Biscayne Blvd
North Miami, FL 33181
Phone (305) 355-8234

Organizations & group practices 7

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": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1043604069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33136",
            "telephone_number": "305-243-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "ALEXANDER",
        "middle_name": "BOEPPLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-27",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME131452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.