Individual provider Active NPI

Lysette Iglesias, M.D

  • Pediatric Endocrinology Physician
  • Miami Lakes, FL
National Provider Identifier
1073749057
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
ME99374 Issued in FL
Practice address
7761 NW 146TH St
Miami Lakes, FL 33016-1559
Phone
(305) 381-5301
Fax
(305) 381-5541
NPI assigned
Jun 4, 2009
Last updated
Feb 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 245766 NY
Pediatrics Physician 208000000X ME99374 FL
Pediatric Endocrinology Physician 2080P0205X ME99374 FL Primary

Addresses

Primary practice location

7761 NW 146TH St
Miami Lakes, FL 33016-1559

Mailing address

8350 Commerce Way Apt 325
Miami Lakes, FL 33016-1636
Phone (786) 502-7112

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
I20101026001037 FL Practitioner - Pediatric MedicinePractitioner - Endocrinology 0840483517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Endocrinology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5801 NW 151St St
Suite 103
Miami Lakes, FL 33014-2437
Phone (305) 381-5301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
245766NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lysette Iglesias, M.D, P.a Pediatric Endocrinology CurrentSince Jul 19, 2010 Accepting new patients

Locations

5801 NW 151st St
Ste 103
Miami Lakes, FL 33014
Phone (305) 381-5301

7761 NW 146th St
Miami Lakes, FL 33016
Phone (305) 822-1243

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1073749057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8350 COMMERCE WAY APT 325",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161636",
            "telephone_number": "786-502-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7761 NW 146TH ST",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161559",
            "telephone_number": "305-381-5301",
            "fax_number": "305-381-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGLESIAS",
        "first_name": "LYSETTE",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "245766",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME99374",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "FL",
            "license": "ME99374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.