Individual provider Active NPI

Rachel Cueto-Clarke

  • Adult Health Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1124599097
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11000123 Issued in FL
Practice address
601 N Flamingo Rd Ste 206
Pembroke Pines, FL 33028-1009
Phone
(954) 844-6825
Fax
(954) 499-1227
NPI assigned
Dec 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN11000123 FL Primary

Addresses

Primary practice location

601 N Flamingo Rd Ste 206
Pembroke Pines, FL 33028-1009

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5603

Other practice location 1

1150 N 35th Ave Ste 300
Hollywood, FL 33021-5428
Phone (954) 265-1490

Other identifiers 1

IdentifierTypeStateIssuer
103333100MedicaidFL

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
I20190503001688 FL Practitioner - Nurse Practitioner 8123360567 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

601 N Flamingo Rd
Suite 206
Pembroke Pines, FL 33028-1009
Phone (954) 844-6825

Hospital & facility affiliations

  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
84.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11000123FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District CurrentSince Aug 1, 2024 Accepting new patients
South Broward Hospital District CurrentSince Aug 1, 2024 Accepting new patients
South Florida Critical Care Services LLC CurrentSince Jan 1, 2021 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

1150 N 35th Ave
Ste 300
Hollywood, FL 33021
Phone (954) 265-1490

1150 N 35th Ave
Ste 590
Hollywood, FL 33021
Phone (954) 265-9500

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

8370 W Flagler St
Ste 226
Miami, FL 33144
Phone (305) 917-5414

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

601 N Flamingo Rd
Ste 206
Pembroke Pnes, FL 33028
Phone (954) 844-6825

Interoperability endpoints

  • Direct secure messaging: rachel.cueto@hca4.eclinicaldirectplus.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1124599097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5603",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N FLAMINGO RD STE 206",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281009",
            "telephone_number": "954-844-6825",
            "fax_number": "954-499-1227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 N 35th Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215428",
            "country_code": "US",
            "telephone_number": "954-265-1490",
            "fax_number": "954-989-0454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUETO-CLARKE",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11000123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103333100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.