Individual provider Active NPI

Michael Nieto, PRESIDENT

  • Community Health Worker
  • Homestead, FL
National Provider Identifier
1194440396
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
156 NE 8TH St
Homestead, FL 33030-4608
Phone
(786) 404-3753
Fax
(786) 404-3735
NPI assigned
Oct 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

156 NE 8TH St
Homestead, FL 33030-4608

Mailing address

156 NE 8TH St
Homestead, FL 33030-4608
Phone (786) 404-3753

Other identifiers 1

IdentifierTypeStateIssuer
987150MedicaidFL

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

Practice roles

OrganizationSpecialtyStatusNew patients
Good Choice Mental Health Center Inc CurrentSince Oct 16, 2022 Accepting new patients

Locations

156 NE 8th St
Homestead, FL 33030
Phone (305) 986-1157

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": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1194440396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 NE 8TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304608",
            "telephone_number": "786-404-3753",
            "fax_number": "786-404-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 NE 8TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304608",
            "telephone_number": "786-404-3753",
            "fax_number": "786-404-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETO",
        "first_name": "MICHAEL",
        "credential": "PRESIDENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "987150",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.