Individual provider Active NPI

Elisa N Mastromarino

  • Certified Registered Nurse Anesthetist
  • Miami, FL
National Provider Identifier
1063070340
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11003556 Issued in FL
Practice address
900 NW 17TH St
Miami, FL 33136-1119
Phone
(305) 326-6543
Fax
(305) 326-6563
NPI assigned
Jun 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9388755 FL
Certified Registered Nurse Anesthetist 367500000X APRN11003556 FL Primary

Addresses

Primary practice location

900 NW 17TH St
Miami, FL 33136-1119

Mailing address

900 NW 17TH St
Miami, FL 33136-1119
Phone (305) 326-6543

Other identifiers 1

IdentifierTypeStateIssuer
RN9388768OtherFLREGISTERED NURSE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190829002020 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961730866 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7500 SW 87TH Ave
Suite 101
Miami, FL 33173-5426
Phone (305) 595-9511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9388755FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Galloway Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2021 Accepting new patients
Galloway Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2021 Accepting new patients
University of Miami CurrentSince Mar 1, 2022 Accepting new patients
University of Miami CurrentSince Mar 1, 2022 Accepting new patients
University of Miami Current Accepting new patients

Locations

7152 Coca Sabal Ln
Fort Myers, FL 33908
Phone (239) 939-9939

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

11011 Sheridan St
Ste 106
Hollywood, FL 33026
Phone (954) 435-0101

515 W State Road 434
Ste 105
Longwood, FL 32750
Phone (407) 260-6000

7875 SW 104th St
Ste 201
Miami, FL 33156
Phone (305) 270-7572

7500 SW 87th Ave
Ste 101
Miami, FL 33173
Phone (305) 595-9511

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

7600 SW 87th Ave
Ste 100
Miami, FL 33173
Phone (786) 235-3750

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

9415 SW 72nd St
Ste 274
Miami, FL 33173
Phone (305) 468-4184

900 NW 17th St
Fl 6
Miami, FL 33136
Phone (305) 243-9110

900 NW 17th St
Miami, FL 33136
Phone (305) 243-6605

Interoperability endpoints

  • Direct secure messaging: emastromarino94779@direct.med.miami.edu

Organizations & group practices 5

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": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1063070340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 NW 17TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361119",
            "telephone_number": "305-326-6543",
            "fax_number": "305-326-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 NW 17TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361119",
            "telephone_number": "305-326-6543",
            "fax_number": "305-326-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTROMARINO",
        "first_name": "ELISA",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9388755",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11003556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "RN9388768",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.