Individual provider Active NPI

Sergio Rodriguez-Chaple

  • Nurse Practitioner
  • Miami, FL
National Provider Identifier
1043791148
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9292612 Issued in FL
Practice address
13925 SW 179TH St
Miami, FL 33177-7743
Phone
(786) 237-9124
NPI assigned
Aug 27, 2018
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9292612 FL
Nurse Practitioner 363L00000X ARNP9292612 FL Primary

Addresses

Primary practice location

13925 SW 179TH St
Miami, FL 33177-7743

Mailing address

10550 NW 77TH CT Ste 308
Hialeah, FL 33016-2072
Phone (305) 863-2233

Other practice location 1

13925 SW 179th St
Miami, FL 33177-7743
Phone (786) 237-9124

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
I20190312000787 FL Practitioner - Nurse Practitioner 1759620628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Complete Care Management Services Aco LLCGroup PAC ID 7012349285, 3 clinicians

Practice addresses (Care Compare)

Miramar, FL 33027
Phone (877) 212-2267

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9292612FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SRC Profesional Corp Current Accepting new patients
Complete Care Management Services Aco LLC CurrentSince Aug 1, 2024 Accepting new patients
Polyclinic Health Center Inc Family Medicine CurrentSince Apr 5, 2022 Accepting new patients

Locations

299 Alhambra Cir
Ste 210
Coral Gables, FL 33134
Phone (305) 766-4260

625 Commerce Dr
Ste 105
Lakeland, FL 33813
Phone (877) 212-2267

3400 Lakeside Dr
Ste 525
Miramar, FL 33027
Phone (877) 212-2267

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FGBIBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/FGBIBD/Endpoint/FGBIBD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1043791148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10550 NW 77TH CT STE 308",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330162072",
            "telephone_number": "305-863-2233",
            "fax_number": "305-504-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13925 SW 179TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331777743",
            "telephone_number": "786-237-9124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13925 SW 179th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331777743",
            "country_code": "US",
            "telephone_number": "786-237-9124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ-CHAPLE",
        "first_name": "SERGIO",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-27",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "9292612",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9292612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.