Individual provider Active NPI

Alberto Leyva

  • Psychiatric/Mental Health Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1144000936
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11026970 Issued in FL
Practice address
1780 Polk St Ste D
Hollywood, FL 33020-4611
Phone
(954) 408-8810
Fax
(954) 408-8837
NPI assigned
Sep 29, 2023
Last updated
May 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11026970 FL Primary

Addresses

Primary practice location

1780 Polk St Ste D
Hollywood, FL 33020-4611

Mailing address

16081 NW 38TH PL
Miami Gardens, FL 33054-6735
Phone (786) 310-9097

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
I20231226000394 FL Practitioner - Nurse Practitioner 3375993868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ezra Medical LLCGroup PAC ID 1355787110, 4 clinicians

Practice addresses (Care Compare)

1780 Polk St
Suite D
Hollywood, FL 33020-4611
Phone (917) 509-2538

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11026970FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ezra Medical LLC CurrentSince Mar 14, 2024 Accepting new patients
Alasake Mental Health Services Corp CurrentSince Feb 17, 2024 Accepting new patients

Locations

1780 Polk St
Ste D
Hollywood, FL 33020
Phone (917) 509-2538

2500 NW 79th Ave
Ste 191
Miami, FL 33122
Phone (786) 631-3152

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1144000936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16081 NW 38TH PL",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330546735",
            "telephone_number": "786-310-9097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 POLK ST STE D",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204611",
            "telephone_number": "954-408-8810",
            "fax_number": "954-408-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYVA",
        "first_name": "ALBERTO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-29",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11026970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.