Organization Active NPI

Tristar Wellness, LLC

  • Multi-Specialty Clinic/Center
  • Miami Beach, FL
National Provider Identifier
1235641770
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
TRISTAR WELLNESS, LLC
Practice address
400 W 41St St Ste 402
Miami Beach, FL 33140-3500
Phone
(305) 604-9595
Fax
(305) 604-9257
NPI assigned
Oct 24, 2017
Last updated
Apr 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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

Authorized official

Name
Reanna Ramkhelawan
Title
President
Phone
(786) 281-2398

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

400 W 41St St Ste 402
Miami Beach, FL 33140-3500

Mailing address

400 W 41St St Ste 402
Miami Beach, FL 33140-3500
Phone (305) 604-9595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190410001765 FL Part B Supplier - Clinic/Group Practice 7416298906 Receives reassigned benefits from 4 practitioners
Practice locations: Miami Beach, FL; Miami, FL
O20190906001252 FL DME Supplier - Physician - Interventional Pain Management 7416298906 Practice locations: Miami Beach, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1046794Tristar Wellness, LLC400 West 41St St Ste 402, Miami Beach, FL 33140Certificate of waiverOct 18, 2027

National Provider Directory

National Provider Directory

Locations

8585 Sunset Dr
Ste 103
Miami, FL 33143
Phone (305) 274-3311

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554681600000",
    "number": "1235641770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 41ST ST STE 402",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403500",
            "telephone_number": "305-604-9595",
            "fax_number": "305-604-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 41ST ST STE 402",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403500",
            "telephone_number": "305-604-9595",
            "fax_number": "305-604-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTAR WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-24",
        "last_updated": "2019-04-08",
        "status": "A",
        "authorized_official_last_name": "RAMKHELAWAN",
        "authorized_official_first_name": "REANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-281-2398"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in 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 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.