Individual provider Active NPI

Nadia C Anas Echegoyen, MD

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1104294958
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN704 Issued in FL
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

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
109603000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
ACN704FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Medical Group of Opa-Locka, LLC. General Practice CurrentSince Oct 16, 2017 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.