Individual provider Active NPI

Ivan Grenier, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1295348654
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11008772 Issued in FL
Practice address
5673 SW 137TH Ave
Miami, FL 33183-1101
Phone
(305) 385-3949
NPI assigned
Aug 26, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11008772 FL
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X APRN11008772 FL Primary

Addresses

Primary practice location

5673 SW 137TH Ave
Miami, FL 33183-1101

Mailing address

14104 SW 42ND Ter
Miami, FL 33175-3644
Phone (786) 587-4549

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
I20230126000062 FL Practitioner - Nurse Practitioner 6406227669 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Health LLCGroup PAC ID 1850838541, 19 clinicians

Practice addresses (Care Compare)

5673 SW 137TH Ave
Miami, FL 33183-1101
Phone (305) 385-3949

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11008772FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Excellence Medical Group Corp Multi-Specialty CurrentSince Mar 8, 2025 Accepting new patients
South Health LLC Multi-Specialty CurrentSince Sep 18, 2024 Accepting new patients
Psychological & Behavioral Therapy Services, Inc Multi-Specialty Past Accepting new patients

Locations

5068 Annunciation Cir
Unit 111
Ave Maria, FL 34142
Phone (239) 304-0054

2001 NW 107th Ave
Ste 412
Doral, FL 33172
Phone (305) 385-3949

5673 SW 137th Ave
Miami, FL 33183
Phone (305) 385-3949

7959 NW 2nd St
Miami, FL 33126
Phone (305) 267-6060

3485 W Flagler St
Ste 300
Miami, FL 33135
Phone (305) 418-0272

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1295348654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14104 SW 42ND TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753644",
            "telephone_number": "786-587-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 SW 137TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331831101",
            "telephone_number": "305-385-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRENIER",
        "first_name": "IVAN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-26",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008772",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11008772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.