Individual provider Active NPI

Rene Sifontes Mejias

  • Family Nurse Practitioner
  • Homestead, FL
National Provider Identifier
1295134591
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11008710 Issued in FL
Practice address
25001 SW 127TH Ave Ste 202
Homestead, FL 33032-5834
Phone
(786) 339-9844
NPI assigned
Aug 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11008710 FL Primary

Addresses

Primary practice location

25001 SW 127TH Ave Ste 202
Homestead, FL 33032-5834

Mailing address

8871 Fontainebleau Blvd Apt 204
Miami, FL 33172-4447
Phone (786) 317-7495

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220601000964 FL Practitioner - Nurse Practitioner 2264810324 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primenet Medical Group Inc CurrentSince May 4, 2022 Accepting new patients
Olivos Medical Center and Spa, LLC CurrentSince Jul 12, 2023 Accepting new patients

Locations

25001 SW 127th Ave
Ste 202
Homestead, FL 33032
Phone (786) 317-7495

7189 Pembroke Rd
Pembroke Pines, FL 33023
Phone (954) 983-1220

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBHEDD/Endpoint/BBHEDD

Organizations & group practices 2

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": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1295134591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8871 FONTAINEBLEAU BLVD APT 204",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331724447",
            "telephone_number": "786-317-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25001 SW 127TH AVE STE 202",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330325834",
            "telephone_number": "786-339-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIFONTES MEJIAS",
        "first_name": "RENE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-22",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.