NPIMap

Individual provider Active NPI

Nicole Cassandra Fernandez, MD

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1356970479
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
165521 Issued in FL
Practice address
1120 NW 14TH St
Miami, FL 33136-2107
Phone
(305) 243-3583
NPI assigned
Apr 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME165521 FL
Internal Medicine Physician 207R00000X 165521 FL Primary

Addresses

Primary practice location

1120 NW 14TH St
Miami, FL 33136-2107

Mailing address

1120 NW 14TH St
Miami, FL 33136-2107
Phone (305) 243-3583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240209000510 FL Practitioner - Hospitalist 9133562895 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lavender Physical Therapy and Wellness, LLCGroup PAC ID 3577916287, 3 clinicians

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-1111

2100 SW 22ND St
Suite 404
Miami, FL 33145-2657
Phone (305) 203-3074

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
165521FLMDInternal Medicine Physician
ME165521FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida CurrentSince Jan 22, 2024 Accepting new patients
Public Health Trust of Miami Dade County Florida Internal Medicine Current Accepting new patients
Lavender Physical Therapy & Wellness, LLC Internal Medicine CurrentSince Mar 20, 2024 Accepting new patients
First Docs PC Internal Medicine CurrentSince Jan 14, 2025 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Jan 22, 2024 Accepting new patients
QMC LLC Hospitalist Past Accepting new patients

Locations

4649 Ponce de Leon Blvd
Ste 302
Coral Gables, FL 33146
Phone (305) 203-3074

2801 NW 79th Ave
Miami, FL 33122
Phone (786) 466-1000

2100 SW 22nd St
Ste 404
Miami, FL 33145
Phone (305) 203-3074

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1120 NW 14th St
Miami, FL 33136
Phone (305) 243-2000

830 Lakeside Cir
Pompano Beach, FL 33060
Phone (954) 247-5801

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: nicole.fernandez@hca6.eclinicaldirectplus.com

Organizations & group practices 6

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1356970479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 NW 14TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331362107",
            "telephone_number": "305-243-3583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 NW 14TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331362107",
            "telephone_number": "305-243-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "NICOLE",
        "middle_name": "CASSANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME165521",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "165521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.