Organization Active NPI

Esencia Primary Care and Medspa Corp

  • Family Health Clinical Nurse Specialist
  • Doral, FL
National Provider Identifier
1164169512
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X
Legal business name
ESENCIA PRIMARY CARE AND MEDSPA CORP
Practice address
10520 NW 26TH St Ste C201
Doral, FL 33172-2161
Phone
(786) 615-5558
NPI assigned
May 17, 2022
Last updated
May 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Authorized official

Name
Mr. Jesus Ramos, APRNNPI 1497211999
Title
Authorized Official
Phone
(786) 615-5058

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X Primary

Addresses

Primary practice location

10520 NW 26TH St Ste C201
Doral, FL 33172-2161

Mailing address

10520 NW 26TH St Ste C201
Doral, FL 33172-2161
Phone (786) 615-5558

Other identifiers 1

IdentifierTypeStateIssuer
11017780OtherFLLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220803002236 FL Part B Supplier - Clinic/Group Practice 6103208418 Receives reassigned benefits from 1 practitioner
Practice locations: Doral, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652745600000",
    "number": "1164169512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10520 NW 26TH ST STE C201",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722161",
            "telephone_number": "786-615-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10520 NW 26TH ST STE C201",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722161",
            "telephone_number": "786-615-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESENCIA PRIMARY CARE AND MEDSPA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A",
        "authorized_official_last_name": "RAMOS",
        "authorized_official_first_name": "JESUS",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "786-615-5058",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "11017780",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.