Jose Antonio Puerto, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9100243 Issued in FL

Practice address

18610 NW 87TH Ave
Suite 101 and 201
Hialeah, FL 33015-3518

Phone

(305) 829-5000

Fax

(305) 829-5033

NPI assigned

Jul 7, 2006

Last updated

Sep 29, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Guidewell Sanitas I, LLC

  dba Clinisanitas

  • Family Medicine Physician
  • Doral, FL
  • NPI 1396124046
  Medicare reassignment NPD
• American Current Care PA

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Pinecrest, FL
  • NPI 1770719296
  Medicare reassignment

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1073546933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 NW 33RD ST",
            "address_2": "SUITE 201",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331221937",
            "telephone_number": "786-408-8502",
            "fax_number": "305-402-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18610 NW 87TH AVE",
            "address_2": "SUITE 101 AND 201",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330153518",
            "telephone_number": "305-829-5000",
            "fax_number": "305-829-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUERTO",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9100243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292159600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Puentes
• Javier Puentes
• Jennifer Diaz Puentes
• Katherine Puertas Aguila, RBT-22-247040
• Anisley Puertas Suarez del Villar
• Desiree Tahiz Puesan
• Tatiana Tahiz Puesan
• Thalia Rosa Puig Sanchez
• Stephanie Nicole Puig, OD
• Xiomara Puig, M.D.

• Physician Assistant in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.