Individual provider Active NPI

Noslen Perez Machado, APRN

  • Family Nurse Practitioner
  • Coral Springs, FL
National Provider Identifier
1053034512
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11021814 Issued in FL
Practice address
4202 NW 76TH Ave
Coral Springs, FL 33065-2034
Phone
(305) 905-9851
NPI assigned
Sep 20, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11021814 FL Primary

Addresses

Primary practice location

4202 NW 76TH Ave
Coral Springs, FL 33065-2034

Mailing address

4202 NW 76TH Ave
Coral Springs, FL 33065-2034
Phone (305) 905-9851

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
I20241119003328 FL Practitioner - Nurse Practitioner 2860927456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Classone Medical CorpGroup PAC ID 8022535970, 2 clinicians

Practice addresses (Care Compare)

154 Monterey Way
Royal Palm Beach, FL 33411-7801
Phone (561) 248-9446

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11021814FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Wound Care of Florida LLC CurrentSince Oct 25, 2024 Accepting new patients

Locations

3648 University Blvd S
Jacksonville, FL 32216
Phone (904) 345-7185

1481 McDonald Ave
Brooklyn, NY 11230
Phone (347) 479-1110

Organizations & group practices 2

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": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1053034512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 NW 76TH AVE",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330652034",
            "telephone_number": "305-905-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 NW 76TH AVE",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330652034",
            "telephone_number": "305-905-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ MACHADO",
        "first_name": "NOSLEN",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11021814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.