Individual provider Active NPI

Carlos M Pablos, M.D.

  • Internal Medicine Physician
  • Miami Lakes, FL
National Provider Identifier
1326036716
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0059290 Issued in FL
Practice address
5801 Miami Lakes Dr E
Miami Lakes, FL 33014-2401
Phone
(305) 821-9115
Fax
(305) 821-9150
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0059290 FL Primary

Addresses

Primary practice location

5801 Miami Lakes Dr E
Miami Lakes, FL 33014-2401

Mailing address

6101 Blue Lagoon Dr Ste 400
Miami, FL 33126-2051

Other identifiers 1

IdentifierTypeStateIssuer
054501500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address carlos.pablos@conviva.eclinicaldirectplus.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110722000600 FL Practitioner - Internal Medicine 2961670617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ponce School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6101 Blue Lagoon Dr
Suite 400
Miami, FL 33126

6101 Blue Lagoon Dr
Suite 400
Miami, FL 33126-2051

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0059290FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients

Locations

440 W 49th St
Hialeah, FL 33012
Phone (305) 828-5000

6101 Blue Lagoon Dr
Ste 400
Miami, FL 33126
Phone (305) 500-2114

4960 SW 72nd Ave
Ste 406
Miami, FL 33155

5801 Miami Lakes Dr E
Miami Lakes, FL 33014
Phone (305) 821-9115

Interoperability endpoints

  • Direct secure messaging: carlos.pablos@conviva.eclinicaldirectplus.com
  • Direct secure messaging: carlos.pablos.1@29601.direct.athenahealth.com

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1326036716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 MIAMI LAKES DR E",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142401",
            "telephone_number": "305-821-9115",
            "fax_number": "305-821-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABLOS",
        "first_name": "CARLOS",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0059290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054501500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carlos.pablos@conviva.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5801 Miami Lakes Dr E",
            "city": "Miami Lakes",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330142401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.