Individual provider Active NPI

Osvaldo Matos Ross

  • Family Nurse Practitioner
  • Palmetto Bay, FL
National Provider Identifier
1194205120
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9410903 Issued in FL
Practice address
9333 SW 152ND St
Palmetto Bay, FL 33157-1778
Phone
(305) 256-5340
NPI assigned
Aug 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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 9410903 FL Primary

Addresses

Primary practice location

9333 SW 152ND St
Palmetto Bay, FL 33157-1778

Mailing address

8529 Franjo Rd
Cutler Bay, FL 33189-2517

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
I20181220002183 FL Practitioner - Nurse Practitioner 6800131772 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9410903FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
JMH Internal Medicine Specialist LLC CurrentSince Mar 10, 2020 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 10, 2020 Accepting new patients
Digestive Diseases Services of South Florida P a CurrentSince Oct 1, 2018 Accepting new patients

Locations

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

1400 NW 12th Ave
Miami, FL 33136
Phone (305) 325-5416

2423 SW 147th Ave
Miami, FL 33185
Phone (305) 317-2426

1611 NW 12th Ave
Apt C150
Miami, FL 33136
Phone (305) 585-3627

9333 SW 152nd St
Palmetto Bay, FL 33157
Phone (305) 251-2500

5501 W 79th St
Ste 400
Burbank, IL 60459

Organizations & group practices 3

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": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1194205120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8529 FRANJO RD",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331892517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9333 SW 152ND ST",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571778",
            "telephone_number": "305-256-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS ROSS",
        "first_name": "OSVALDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9410903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto Bay, FL

Sources for this page

Verify at the official NPI Registry.