Individual provider Active NPI

Jessica Mizrachi Pagelsohn, PSYD

  • Clinical Psychologist
  • North Miami Beach, FL
National Provider Identifier
1194521526
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY12580 Issued in FL
Practice address
1380 NE Miami Gardens Dr Ste 242
North Miami Beach, FL 33179-4750
Phone
(305) 396-6009
NPI assigned
Feb 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY12580 FL Primary

Addresses

Primary practice location

1380 NE Miami Gardens Dr Ste 242
North Miami Beach, FL 33179-4750

Mailing address

21120 Highland Lakes Blvd
Miami, FL 33179-1656
Phone (305) 803-9288

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
PY12580FLMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1194521526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21120 HIGHLAND LAKES BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331791656",
            "telephone_number": "305-803-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 NE MIAMI GARDENS DR STE 242",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331794750",
            "telephone_number": "305-396-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZRACHI PAGELSOHN",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY12580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.