Individual provider Active NPI

Yenny M Ceballos, ARNP-BC

  • Family Nurse Practitioner
  • South Miami, FL
National Provider Identifier
1063848356
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9264957 Issued in FL
Practice address
5975 Sunset Dr Ste 402
South Miami, FL 33143-5198
Phone
(305) 968-1996
NPI assigned
Sep 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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 ARNP9264957 FL Primary

Addresses

Primary practice location

5975 Sunset Dr Ste 402
South Miami, FL 33143-5198

Mailing address

12944 SW 222ND Street
Miami, FL 33170
Phone (305) 968-1996

Other identifiers 1

IdentifierTypeStateIssuer
012051400MedicaidFL

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
I20140620000659 FL Practitioner - Nurse Practitioner 1052535663 Reassigns benefits to 7 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Outpatient Services Inc CurrentSince Nov 16, 2015 Accepting new patients
Urgent Care Physicians of Country Walk LLC CurrentSince Aug 1, 2016 Accepting new patients
Urgent Care Physicians of West Kendall LLC CurrentSince Aug 1, 2016 Accepting new patients
Baptist Outpatient Services Inc CurrentSince Nov 16, 2015 Accepting new patients
Criticare Clinics Inc CurrentSince Jun 5, 2015 Accepting new patients
Urgent Care Physicians of Tamiami LLC CurrentSince Aug 1, 2016 Accepting new patients
Urgent Care Physicians of Westchester LLC CurrentSince Aug 1, 2016 Accepting new patients
Urgent Care Physicians of Palmetto Bay LLC CurrentSince Aug 1, 2016 Accepting new patients

Locations

6264 W Sample Rd
Ste 120
Coral Springs, FL 33067
Phone (954) 837-1020

6264 W Sample Rd
Ste 100
Coral Springs, FL 33067
Phone (954) 837-1010

4741 S University Dr
Davie, FL 33328
Phone (954) 837-1050

13001 SW 88th St
Miami, FL 33186
Phone (786) 596-3800

14660 SW 8th St
#100
Miami, FL 33184
Phone (786) 596-4100

13500 SW 152nd St
Miami, FL 33177
Phone (786) 596-4300

8840 SW 40th St
Ste 100
Miami, FL 33165
Phone (786) 596-3890

14701 NW 77th Ave
Miami Lakes, FL 33014
Phone (305) 669-2833

8750 SW 144th St
Palmetto Bay, FL 33176
Phone (786) 596-3840

15885 Pines Blvd
Pembroke Pines, FL 33027
Phone (954) 837-1300

10520 Forest Hill Blvd
Ste 300
Wellington, FL 33414
Phone (561) 204-9355

Organizations & group practices 8

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": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426723200000",
    "number": "1063848356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12944 SW 222ND STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33170",
            "telephone_number": "305-968-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5975 SUNSET DR STE 402",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435198",
            "telephone_number": "305-968-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEBALLOS",
        "first_name": "YENNY",
        "middle_name": "M",
        "credential": "ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2015-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9264957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012051400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.