Organization Active NPI

Truvida Medical Group LLC

  • Family Medicine Physician
  • Palmetto Bay, FL
National Provider Identifier
1265104590
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TRUVIDA MEDICAL GROUP LLC
Practice address
9299 SW 152ND St Ste 206
Palmetto Bay, FL 33157-1776
Phone
(786) 701-9211
Fax
(305) 402-8044
NPI assigned
Oct 5, 2021
Last updated
Oct 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Authorized official

Name
Karen Figueredo, MD
Title
Manager
Phone
(786) 701-9211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

9299 SW 152ND St Ste 206
Palmetto Bay, FL 33157-1776

Mailing address

9299 SW 152ND St Ste 206
Palmetto Bay, FL 33157-1776
Phone (786) 701-9211

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://static.practicefusion.com/apps/ehr/index.html#/PF/home/main

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220201000390 FL Part B Supplier - Clinic/Group Practice 9234522012 Receives reassigned benefits from 4 practitioners
Practice locations: Palmetto Bay, FL

National Provider Directory

National Provider Directory

Locations

9261 SW 152nd St
Ste 207
Palmetto Bay, FL 33157

Practitioners & affiliated clinicians

Practitioners 4

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": "1633392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1265104590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9299 SW 152ND ST STE 206",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571776",
            "telephone_number": "786-701-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9299 SW 152ND ST STE 206",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571776",
            "telephone_number": "786-701-9211",
            "fax_number": "305-402-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUVIDA MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "FIGUEREDO",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "786-701-9211",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://static.practicefusion.com/apps/ehr/index.html#/PF/home/main",
            "affiliation": "N",
            "endpointDescription": "https://static.practicefusion.com/apps/ehr/index.html#/PF/home/main",
            "address_1": "9299 SW 152nd St Ste 206",
            "city": "Palmetto Bay",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331571776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palmetto Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.