Individual provider Active NPI

Kenia Ortiz

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1376048496
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11025063 Issued in FL
Practice address
11004 SW 123Rd Ave
Miami, FL 33186-4809
Phone
(786) 702-6609
NPI assigned
Mar 29, 2018
Last updated
Jun 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11025063 FL Primary

Addresses

Primary practice location

11004 SW 123Rd Ave
Miami, FL 33186-4809

Mailing address

11004 SW 123Rd Ave
Miami, FL 33186-4809
Phone (786) 702-6609

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250502000719 FL Practitioner - Nurse Practitioner 1850817891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southwest Medical Group PAGroup PAC ID 8426391871, 11 clinicians

Practice addresses (Care Compare)

5829 S Congress Ave
Atlantis, FL 33462-1347
Phone (561) 342-0002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11025063FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Group, P.a. CurrentSince Mar 1, 2025 Accepting new patients
Syx, Corp. Past Accepting new patients

Locations

5829 S Congress Ave
Atlantis, FL 33462
Phone (561) 253-6794

3640 N Federal Hwy
Ste 5
Lighthouse Point, FL 33064
Phone (754) 732-2444

7480 Fairway Dr
Ste 106
Miami Lakes, FL 33014
Phone (305) 704-0449

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1376048496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11004 SW 123RD AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864809",
            "telephone_number": "786-702-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11004 SW 123RD AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864809",
            "telephone_number": "786-702-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "KENIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11025063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.