Individual provider Active NPI

Melissa Maria Berrocal, RD, MS

  • Registered Dietitian
  • Miami, FL
National Provider Identifier
1194975615
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND 5394 Issued in FL
Practice address
11001 SW 26TH St
Miami, FL 33165-2303
Phone
(305) 490-5070
Fax
(305) 553-8563
NPI assigned
Sep 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X ND 5394 FL
Registered Dietitian 133V00000X ND 5394 FL Primary

Addresses

Primary practice location

11001 SW 26TH St
Miami, FL 33165-2303

Mailing address

11001 SW 26TH St
Miami, FL 33165-2303
Phone (305) 490-5070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100204000371 FL Practitioner - Registered Dietitian Or Nutrition Professional 6002959699 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
ND 5394FLMDNutrition Education Nutritionist

Interoperability endpoints

  • Direct secure messaging: berrocal.melissa.p1@direct.caremax.nextgenshare.com

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": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1194975615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 SW 26TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331652303",
            "telephone_number": "305-490-5070",
            "fax_number": "305-553-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11001 SW 26TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331652303",
            "telephone_number": "305-490-5070",
            "fax_number": "305-553-8563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERROCAL",
        "first_name": "MELISSA",
        "middle_name": "MARIA",
        "credential": "RD, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-19",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "FL",
            "license": "ND 5394",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND 5394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.