Active NPI
Jessica Ruiz, APRN
- Nurse Practitioner
- Pembroke Pines, FL
National Provider Identifier
1093397895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 11008496
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11008496 | FL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gastro Health, LLC | Multi-Specialty | Current | Accepting new patients |
| Meharry Health Network, PC | Multi-Specialty | Current | Accepting new patients |
| Guidewell Sanitas I, LLC | Multi-Specialty | Current | Accepting new patients |
| Gastro Health LLC | Multi-Specialty | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.