Individual provider Active NPI

John G. Padron, M.D.

  • Specialist
  • North Miami Beach, FL
National Provider Identifier
1205867520
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME50431 Issued in FL
Practice address
1865 NE 163Rd St
North Miami Beach, FL 33162-4805
Phone
(305) 948-9958
Fax
(305) 948-9518
NPI assigned
Jul 5, 2006
Last updated
Apr 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME50431 FL Primary
Family Medicine Physician 207Q00000X ME50431 FL

Addresses

Primary practice location

1865 NE 163Rd St
North Miami Beach, FL 33162-4805

Mailing address

1865 NE 163Rd St
North Miami Beach, FL 33162-4805
Phone (305) 948-9958

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 305-948-9518 Other

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME50431FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sussman & Staller MD PA PastSince Dec 30, 2015 Accepting new patients
Melissa Medical Center Corp Past Accepting new patients

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, 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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1205867520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 NE 163RD ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624805",
            "telephone_number": "305-948-9958",
            "fax_number": "305-948-9518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 NE 163RD ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624805",
            "telephone_number": "305-948-9958",
            "fax_number": "305-948-9518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADRON",
        "first_name": "JOHN",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME50431",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME50431",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "305-948-9518",
            "affiliation": "N",
            "endpointDescription": "fax",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "fax",
            "address_1": "1865 NE 163rd St",
            "city": "North Miami Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331624805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Apr 25, 2024; 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.