Active NPI
Nadia C Anas Echegoyen, MD
- General Practice Physician
- Miami, FL
National Provider Identifier
1104294958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- ACN704
- Practice address
- 1621 SW 107TH Ave
Miami, FL 33165-7344 - Phone
- (786) 422-6525
- Fax
- (786) 621-7815
- NPI assigned
- Sep 10, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | ACN704 | FL | Primary |
Addresses
Primary practice location
1621 SW 107TH Ave
Miami, FL 33165-7344
Mailing address
6100 Blue Lagoon Dr Ste 365
Miami, FL 33126-7010
Phone (786) 322-7333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109603000 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nadia.echegoyen@cmg.eclinicaldirectplus.com | Other |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151214001492 | FL | Practitioner - General Practice | 4688975840 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACN704 | FL | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Medical Group of Opa-Locka, LLC. | General Practice | Current | Accepting new patients |
| Access Medical Group of Perrine, LLC. | General Practice | Past | Accepting new patients |
Locations
6100 Blue Lagoon Dr
Ste 365
Miami, FL 33126
Phone (786) 322-7333
321 Opa Locka Blvd
Opa Locka, FL 33054
Phone (786) 476-3333
Interoperability endpoints
- nadia.echegoyen@cmg.eclinicaldirectplus.com
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.
-
- Family Medicine Physician
- Opa Locka, FL
- NPI 1790044287
FL, General Practice
-
- Family Medicine Physician
- Miami, FL
- NPI 1578845129
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616371200000",
"number": "1104294958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6100 BLUE LAGOON DR STE 365",
"city": "MIAMI",
"state": "FL",
"postal_code": "331267010",
"telephone_number": "786-322-7333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1621 SW 107TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331657344",
"telephone_number": "786-422-6525",
"fax_number": "786-621-7815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECHEGOYEN",
"first_name": "NADIA",
"middle_name": "C ANAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-10",
"last_updated": "2021-03-22",
"certification_date": "2021-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "ACN704",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109603000",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nadia.echegoyen@cmg.eclinicaldirectplus.com",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "health information has changed",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "other",
"address_1": "1621 SW 107th Ave",
"city": "Miami",
"state": "FL",
"country_code": "US",
"postal_code": "331657344",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.