Individual provider Active NPI

Massiel Millan Gomez, ARNP

  • Pediatric Nurse Practitioner
  • Miami, FL
National Provider Identifier
1376992115
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN9317568 Issued in FL
Practice address
1601 NW 12TH Ave FL 1
Miami, FL 33136-1005
Phone
(305) 243-3100
Fax
(305) 243-4678
NPI assigned
Jun 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN9317568 FL Primary

Addresses

Primary practice location

1601 NW 12TH Ave FL 1
Miami, FL 33136-1005

Mailing address

1601 NW 12TH Ave FL 1
Miami, FL 33136-1005
Phone (305) 243-3100

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
I20230216001585 FL Practitioner - Nurse Practitioner 7911287974 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9317568FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Nurse Practitioner CurrentSince Dec 1, 2022 Accepting new patients
University of Miami CurrentSince Dec 1, 2022 Accepting new patients
University of Miami Current Accepting new patients
University of Miami Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

15155 SW 97th Ave
Ste 240
Miami, FL 33176

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

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

1475 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4200

1601 NW 12th Ave
Fl 1
Miami, FL 33136
Phone (305) 243-3166

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mgomez99778@direct.med.miami.edu

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1376992115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 NW 12TH AVE FL 1",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-243-3100",
            "fax_number": "305-243-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 NW 12TH AVE FL 1",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-243-3100",
            "fax_number": "305-243-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "MASSIEL",
        "middle_name": "MILLAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN9317568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.