Maka Badridze

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

APRN11029722 Issued in FL

Practice address

1450 W Golfview Dr
Pembroke Pines, FL 33026-3121

Phone

(305) 491-8032

NPI assigned

Mar 6, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Public Health Trust of Miami Dade County FloridaGroup PAC ID 0244380434, 469 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• HealthSun Health Plans Network

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.

• Public Health Trust of Miami Dade County Florida

  • General Practice Physician
  • Miami, FL
  • NPI 1134384423
  Medicare reassignment Care Compare group NPD
• Public Health Trust of Miami Dade County Florida

  • General Practice Physician
  • Miami, FL
  • NPI 1326780016
  NPD
• Public Health Trust of Miami Dade County Florida

  • General Practice Physician
  • Hialeah, FL
  • NPI 1841149093
  NPD
• Public Health Trust of Dade County Florida

  • Family Medicine Physician
  • Miami, FL
  • NPI 1902978695
  NPD (past)

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1346007242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 W GOLFVIEW DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263121",
            "telephone_number": "305-491-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 W GOLFVIEW DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263121",
            "telephone_number": "305-491-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADRIDZE",
        "first_name": "MAKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11029722",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11029722",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ricardo Luis Bacallao, DC
• Back Mastery Rehabilitation Inc
• Back to Basic Wellness Services LLC
• Yolanda Bacon-Green, MD
• Reshma Baddaloo
• Stephanie Marie Baer
• Daniela Victoria Baez Amador
• Alejandro Jose Baez Gutierrez
• Lila De la Caridad Baez Lopez
• Stacy Ann Bahadur

• Acute Care Nurse Practitioner in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Acute Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.