Individual provider Active NPI

Raul Ventura, MSN, NP-C

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1194027185
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11004925 Issued in FL
Practice address
15411 SW 39TH Ter
Miami, FL 33185-5418
Phone
(786) 229-6636
Fax
(786) 206-3178
NPI assigned
Nov 23, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11004925 FL Primary

Addresses

Primary practice location

15411 SW 39TH Ter
Miami, FL 33185-5418

Mailing address

15411 SW 39TH Ter
Miami, FL 33185-5418
Phone (786) 229-6636

Other identifiers 2

IdentifierTypeStateIssuer
11004925OtherFLHMO
11004925MedicaidFL

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
I20200715001052 FL Practitioner - Nurse Practitioner 6901229574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11004925FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MV Mental Solutions, Inc Past Accepting new patients

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

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1194027185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15411 SW 39TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855418",
            "telephone_number": "786-229-6636",
            "fax_number": "786-206-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15411 SW 39TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855418",
            "telephone_number": "786-229-6636",
            "fax_number": "786-206-3178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTURA",
        "first_name": "RAUL",
        "credential": "MSN, NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-23",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11004925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO",
            "identifier": "11004925",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11004925",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.