Individual provider Active NPI

Maryam Abdullah H Aldossary, RN

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1265196281
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11016301 Issued in FL
Practice address
201 SE 2ND Ave Apt 2521
Miami, FL 33131-2260
Phone
(312) 721-0364
NPI assigned
Oct 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 9510472 FL
Family Nurse Practitioner 363LF0000X 11016301 FL Primary

Addresses

Primary practice location

201 SE 2ND Ave Apt 2521
Miami, FL 33131-2260

Mailing address

201 SE 2ND Ave Apt 2521
Miami, FL 33131-2260
Phone (312) 721-0364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211130000377 FL Practitioner - Nurse Practitioner 7315337771 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
9510472FLMDRegistered Nurse
11016301FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr GS Urgent Care LLC Multi-Specialty CurrentSince Nov 8, 2021 Accepting new patients

Locations

1425 S Congress Ave
Delray Beach, FL 33445
Phone (561) 330-9363

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1265196281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SE 2ND AVE APT 2521",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331312260",
            "telephone_number": "312-721-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SE 2ND AVE APT 2521",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331312260",
            "telephone_number": "312-721-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALDOSSARY",
        "first_name": "MARYAM",
        "middle_name": "ABDULLAH H",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9510472",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11016301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.