Organization Active NPI

Novellas'S Health Care LLC

  • Family Medicine Physician
  • Hialeah, FL
National Provider Identifier
1295468684
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NOVELLAS'S HEALTH CARE LLC
Practice address
17855 NW 78TH Ave
Hialeah, FL 33015-2805
Phone
(305) 530-8979
Fax
(305) 530-8979
NPI assigned
Jul 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Authorized official

Name
Dr. Jorge Novellas Zayas, APRNNPI 1053920173
Title
Owner
Phone
(786) 717-3164

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

17855 NW 78TH Ave
Hialeah, FL 33015-2805

Mailing address

17855 NW 78TH Ave
Hialeah, FL 33015-2805
Phone (305) 530-8979

Other identifiers 1

IdentifierTypeStateIssuer
1053920173MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221006002513 FL Part B Supplier - Clinic/Group Practice 1850777343 Receives reassigned benefits from 1 practitioner
Practice locations: Hialeah, 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
10D2271881Novellas'S Health Care LLC17855 NW 78TH Ave, Hialeah, FL 33015Certificate of waiverNov 8, 2026

National Provider Directory

National Provider Directory

Locations

17855 NW 78th Ave
Hialeah, FL 33015
Phone (305) 530-8979

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1295468684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17855 NW 78TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330152805",
            "telephone_number": "305-530-8979",
            "fax_number": "305-530-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17855 NW 78TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330152805",
            "telephone_number": "305-530-8979",
            "fax_number": "305-530-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVELLAS'S HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "NOVELLAS ZAYAS",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-717-3164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053920173",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.