Individual provider Active NPI

Mireisy Mesa Villalonga, NP

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1093462467
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11016875 Issued in FL
Practice address
11729 SW 116TH Ter
Miami, FL 33186-3982
Phone
(786) 306-0348
NPI assigned
Mar 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11016875 FL Primary

Addresses

Primary practice location

11729 SW 116TH Ter
Miami, FL 33186-3982

Mailing address

11729 SW 116TH Ter
Miami, FL 33186-3982
Phone (786) 306-0348

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
I20230126000058 FL Practitioner - Nurse Practitioner 3779954938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Miami Psychiatric Services, LLCGroup PAC ID 2062795909, 4 clinicians

Practice addresses (Care Compare)

12260 SW 8TH St
Suite 154
Miami, FL 33184-1508
Phone (786) 409-5503

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health and Wellness Center of Miami Inc CurrentSince Oct 19, 2022 Accepting new patients
Miami Psychiatric Services, LLC. CurrentSince Apr 1, 2023 Accepting new patients

Locations

1671 W 37th St
Ste 4
Hialeah, FL 33012
Phone (305) 362-4594

12260 SW 8th St
Ste 154
Miami, FL 33184
Phone (786) 409-5503

759 NW 22nd Ave
Miami, FL 33125
Phone (305) 541-5245

Organizations & group practices 2

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": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1093462467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11729 SW 116TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331863982",
            "telephone_number": "786-306-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11729 SW 116TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331863982",
            "telephone_number": "786-306-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESA VILLALONGA",
        "first_name": "MIREISY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11016875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.