Individual provider Active NPI

Grisel Mac Williams, MD

  • Internal Medicine Physician
  • Hialeah, FL
National Provider Identifier
1053396549
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0045706 Issued in FL
Practice address
810 E 39TH PL
Hialeah, FL 33013-2863
Phone
(305) 691-7018
Fax
(305) 691-5814
NPI assigned
Dec 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0045706 FL
Internal Medicine Physician 207R00000X ME0045706 FL Primary

Addresses

Primary practice location

810 E 39TH PL
Hialeah, FL 33013-2863

Mailing address

810 E 39 PL.
Hialeah, FL 33013
Phone (305) 691-7018

Other identifiers 1

IdentifierTypeStateIssuer
047895400MedicaidFL

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
I20110714000543 FL Practitioner - Internal Medicine 7315125465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

810 E 39TH PL
Hialeah, FL 33013-2863

Hospital & facility affiliations

  • MGN Healthcare Services Home health agency, Miami Lakes, FL, CCN 103179

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0045706FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Grisel Mac Williams MD PA Specialist CurrentSince Jun 29, 2010 Accepting new patients

Locations

810 E 39th Pl
Hialeah, FL 33013
Phone (305) 691-7018

18044 NW 6th St
Ste 101
Pembroke Pines, FL 33029
Phone (954) 270-1723

Interoperability endpoints

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

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.

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1053396549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 E 39 PL.",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "33013",
            "telephone_number": "305-691-7018",
            "fax_number": "305-691-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E 39TH PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330132863",
            "telephone_number": "305-691-7018",
            "fax_number": "305-691-5814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAC WILLIAMS",
        "first_name": "GRISEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0045706",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0045706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047895400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.