Organization Active NPI

Maurin Jimenez MD PA

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1063803872
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME95052 Issued in FL
Legal business name
MAURIN JIMENEZ MD PA
Practice address
962 SW 82ND Ave
Miami, FL 33144-4271
Phone
(786) 619-3360
Fax
(786) 619-3360
NPI assigned
Feb 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Authorized official

Name
Dr. Maurin Jimenez, MDNPI 1982783353
Title
President
Phone
(786) 619-3360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X ME95052 FL Primary

Addresses

Primary practice location

962 SW 82ND Ave
Miami, FL 33144-4271

Mailing address

962 SW 82ND Ave
Miami, FL 33144-4271
Phone (786) 619-3360

Other identifiers 3

IdentifierTypeStateIssuer
275404500MedicaidFL
53011OtherFLBLUE CROSS, BLUE SHIELD
9021195OtherFLAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251003001534 FL Part B Supplier - Clinic/Group Practice 7416453865 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2321628Maurin Jimenez MD PA962 SW 82ND Ave, Miami, FL 33144Certificate of waiverApr 6, 2027

National Provider Directory

National Provider Directory

Locations

962 SW 82nd Ave
Miami, FL 33144
Phone (305) 265-4167

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471219200000",
    "number": "1063803872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "962 SW 82ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331444271",
            "telephone_number": "786-619-3360",
            "fax_number": "786-619-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "962 SW 82ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331444271",
            "telephone_number": "786-619-3360",
            "fax_number": "786-619-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAURIN JIMENEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-16",
        "last_updated": "2016-08-15",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "MAURIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-619-3360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME95052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275404500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS, BLUE SHIELD",
            "identifier": "53011",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9021195",
            "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 Aug 15, 2016; 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.