Individual provider Active NPI

Jessica Ruiz, APRN

  • Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1093397895
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11008496 Issued in FL
Practice address
16511 NW 1St St
Pembroke Pines, FL 33028-1440
Phone
(305) 323-2764
NPI assigned
Apr 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 11008496 FL Primary

Addresses

Primary practice location

16511 NW 1St St
Pembroke Pines, FL 33028-1440

Mailing address

16511 NW 1St St
Pembroke Pines, FL 33028-1440
Phone (305) 323-2764

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
I20220928002194 FL Practitioner - Nurse Practitioner 5991181992 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11008496FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro Health, LLC Multi-Specialty CurrentSince Nov 7, 2022 Accepting new patients
Meharry Health Network, PC Multi-Specialty CurrentSince Apr 7, 2024 Accepting new patients
Guidewell Sanitas I, LLC Multi-Specialty Current Accepting new patients
Gastro Health LLC Multi-Specialty CurrentSince Nov 7, 2022 Accepting new patients

Locations

4675 Linton Blvd
Ste 202
Delray Beach, FL 33445
Phone (561) 495-5700

8400 NW 33rd St
Ste 201
Doral, FL 33122
Phone (786) 882-2869

3661 S Miami Ave
Ste 907
Miami, FL 33133
Phone (305) 856-7333

7243 Della Dr
Orlando, FL 32819
Phone (407) 381-7366

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.

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1093397895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16511 NW 1ST ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281440",
            "telephone_number": "305-323-2764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16511 NW 1ST ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281440",
            "telephone_number": "305-323-2764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JESSICA",
        "name_prefix": "Miss",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11008496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.