Organization Active NPI

Grisel Mac Williams MD PA

  • Internal Medicine Physician
  • Hialeah, FL
National Provider Identifier
1083910202
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GRISEL MAC WILLIAMS MD PA
Practice address
810 E 39TH PL
Hialeah, FL 33013-2863
Phone
(305) 691-7018
Fax
(305) 691-5814
NPI assigned
Feb 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Michel Diaz
Title
Office Manager
Phone
(305) 691-7018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

810 E 39TH PL
Hialeah, FL 33013-2863

Mailing address

810 E 39TH PL
Hialeah, FL 33013-2863
Phone (305) 691-7018

Other practice location 1

18044 NW 6th St Ste 101
Pembroke Pines, FL 33029-2824
Phone (954) 885-9904

Other identifiers 1

IdentifierTypeStateIssuer
047895400MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110621000149 FL Part B Supplier - Clinic/Group Practice 8325226475 Receives reassigned benefits from 3 practitioners
Practice locations: Hialeah, FL; Pembroke Pines, 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
10D2063191Grisel Mac Williams MD PA18044 NW 6TH St Ste 102, Pembroke Pines, FL 33029Certificate of waiverJul 28, 2027

National Provider Directory

National Provider Directory

Locations

810 E 39th Pl
Hialeah, FL 33013
Phone (305) 691-7018

Practitioners & affiliated clinicians

Practitioners 5

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": "1296864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1083910202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 E 39TH PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330132863",
            "telephone_number": "305-691-7018",
            "fax_number": "305-691-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E 39TH PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330132863",
            "telephone_number": "305-691-7018",
            "fax_number": "305-691-5814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18044 NW 6th St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330292824",
            "country_code": "US",
            "telephone_number": "954-885-9904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRISEL MAC WILLIAMS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-05",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "MICHEL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "305-691-7018"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047895400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.