NPIMap

Organization Active NPI

Public Health Trust of Miami Dade County Florida

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, FL
National Provider Identifier
1366514705
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
8511 Issued in FL
Legal business name
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Practice address
1695 NW 9TH Ave
Miami, FL 33136-1409
Phone
(305) 355-8234
Fax
(305) 355-8235
NPI assigned
Nov 14, 2006
Organization subpart
Yes
Parent organization
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Authorized official

Name
Mr. Mark T Knight
Title
Chief Financial Officer
Phone
(305) 585-7979

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X
Hearing and Speech Clinic/Center 261QH0700X 8511 FL
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 8511 FL Primary

Addresses

Primary practice location

1695 NW 9TH Ave
Miami, FL 33136-1409

Mailing address

PO Box 12493
Miami, FL 33101-2493
Phone (786) 466-8080

Other identifiers 2

IdentifierTypeStateIssuer
010042128MedicaidFL
101142128MedicaidFL

Other names 1

  • JMH Community Mental Health Outpatient Clinics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031117000037 FL Part B Supplier - Clinic/Group Practice 8628981925 Receives reassigned benefits from 94 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami, FL
O20060208000214 FL Part A Provider - Hospital 8628981925 22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami, FL; North Miami Beach, FL; Miami Beach, FL; North Miami, FL; Opa Locka, FL; Village of Palmetto Bay, FL; Homestead, FL; Doral, FL…

Hospital certification: CCN 100022

Legal name
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jul 9, 2020
Beds
2,255
Ownership / control type
Hospital district or authority
Organization structure
GovernmentNon-profit
Enrollment address
1611 NW 12TH Ave
Miami, FL 33136-1005
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

Care Compare: Hospital

Medicare Care Compare
Listed as
Jackson Health SystemCCN 100022
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Dianne M Parker MD54 organizations share this tax ID, including this one
Part of
Dianne M Parker MD

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1695 NW 9th Ave
Ste 3308
Miami, FL 33136
Phone (305) 355-9128

Networks

  • HealthSun Health Plans Network

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Myriam Torres Individual Corporate OfficerVP Revenue Cycle Management Mar 21, 2016
Corporate DirectorVP Revenue Cycle Management Mar 21, 2016
W-2 Managing EmployeeVP Revenue Cycle Management Mar 21, 2016
Operational/Managerial ControlVP Revenue Cycle Management Mar 21, 2016
Mark T Knight Individual Corporate OfficerEvp, Chief Financial Officer Nov 1, 2010
Corporate DirectorEvp, Chief Financial Officer Nov 1, 2011
W-2 Managing EmployeeEvp, Chief Financial Officer Nov 1, 2010
Operational/Managerial ControlEvp, Chief Financial Officer Nov 1, 2011
Carlos Migoya Individual Corporate OfficerChief Executive Officer May 2, 2011
Corporate DirectorChief Executive Officer May 2, 2011
W-2 Managing EmployeeChief Executive Officer May 2, 2011
Operational/Managerial ControlChief Executive Officer May 2, 2011
Public Health Trust of Miami Dade County Florida Organization, Miami, FL Non-profit Operational/Managerial Control Oct 1, 1973 100%

Owners & managing parties with NPI records 12

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 46

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

View all 46

Affiliated clinicians 1,674

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,674

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492473600000",
    "number": "1366514705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12493",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331012493",
            "telephone_number": "786-466-8080",
            "fax_number": "305-355-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 NW 9TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361409",
            "telephone_number": "305-355-8234",
            "fax_number": "305-355-8235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY",
        "enumeration_date": "2006-11-14",
        "last_updated": "2017-04-18",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "305-585-7979",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "FL",
            "license": "8511",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "FL",
            "license": "8511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010042128",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101142128",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JMH Community Mental Health Outpatient Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.