Individual provider Active NPI

Yiscel Maria Pascual Bermudez

  • Case Manager/Care Coordinator
  • Cutler Bay, FL
National Provider Identifier
1174085419
Registry record updated May 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
CBHCMS0102588 Issued in FL
Practice address
9333 SW 227TH St Unit 1
Cutler Bay, FL 33190-1947
Phone
(786) 740-0516
NPI assigned
Apr 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X CBHCM102551 FL
Case Manager/Care Coordinator 171M00000X CBHCMS0102588 FL Primary

Addresses

Primary practice location

9333 SW 227TH St Unit 1
Cutler Bay, FL 33190-1947

Mailing address

9333 SW 227TH St Unit 1
Cutler Bay, FL 33190-1947
Phone (786) 740-0516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CBHCMS0102588FLMDCase Manager/Care Coordinator
CBHCM102551FLMDCase Management Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Wellness Support Corp Case Manager/Care Coordinator CurrentSince Feb 1, 2024 Accepting new patients

Locations

12651 S Dixie Hwy
Ste 309
Pinecrest, FL 33156
Phone (786) 399-3810

Organizations & group practices 1

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": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684540800000",
    "number": "1174085419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9333 SW 227TH ST UNIT 1",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331901947",
            "telephone_number": "786-740-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9333 SW 227TH ST UNIT 1",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331901947",
            "telephone_number": "786-740-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCUAL BERMUDEZ",
        "first_name": "YISCEL",
        "middle_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2023-05-20",
        "certification_date": "2023-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "FL",
            "license": "CBHCM102551",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "CBHCMS0102588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.