NPIMap

Individual provider Active NPI

Jorge Luis Penalver Leon, M.D.

  • Cardiovascular Disease Physician
  • Miami, FL
National Provider Identifier
1073995544
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME157432 Issued in FL
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1005
Phone
(305) 243-7067
NPI assigned
Jun 22, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME157432 FL Primary
Internal Medicine Physician 207R00000X MD464582 PA
Student in an Organized Health Care Education/Training Program 390200000X MT209582 PA
Student in an Organized Health Care Education/Training Program 390200000X TRN25839 FL

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1005

Mailing address

1611 NW 12TH Ave
Miami, FL 33136-1005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220815002221 FL Practitioner - Cardiovascular Disease (Cardiology) 8123401734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Health Trust of Miami Dade County FloridaGroup PAC ID 0244380434, 469 clinicians

Practice addresses (Care Compare)

1801 NW 9TH Ave
FL 2
Miami, FL 33136-1101
Phone (786) 466-8490

Hospital & facility affiliations

  • Jackson Health System Hospital, Miami, FL, CCN 100022
  • Gov Juan F Luis Hospital & Medical Ctr Hospital, St Croix, VI, CCN 480002

Merit-based Incentive Payment System (MIPS)

Final score
91.01 of 100Reported as group
Quality
72.99
Promoting interoperability
82
Improvement activities
40
Cost
78.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD464582PAMDInternal Medicine Physician
TRN25839FLMDStudent in an Organized Health Care Education/Training Program
MT209582PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida CurrentSince Aug 1, 2022 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Aug 1, 2022 Accepting new patients
Public Health Trust of Miami Dade County Florida Internal Medicine Current Accepting new patients
Public Health Trust of Dade County Florida Past Accepting new patients

Locations

1801 NW 9th Ave
Fl 2
Miami, FL 33136
Phone (786) 466-8490

1801 NW 9th Ave
Ste 600
Miami, FL 33136
Phone (305) 585-4564

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

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 4

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.

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1073995544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-243-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENALVER LEON",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME157432",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD464582",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT209582",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN25839",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.