Individual provider Active NPI

Ernesto Perez Regalado, APRN

  • Family Nurse Practitioner
  • Homestead, FL
National Provider Identifier
1386360709
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11022452 Issued in FL
Practice address
12171 SW 268TH St
Homestead, FL 33032-8001
Phone
(305) 278-0200
NPI assigned
Oct 17, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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 APRN11022452 FL Primary

Addresses

Primary practice location

12171 SW 268TH St
Homestead, FL 33032-8001

Mailing address

12171 SW 268TH St
Homestead, FL 33032-8001

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
I20230217001772 FL Practitioner - Nurse Practitioner 3173995214 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11022452FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Care of South Florida, Inc. CurrentSince Feb 6, 2023 Accepting new patients
American Care of South Florida, Inc. CurrentSince Feb 6, 2023 Accepting new patients
American Care of North Florida, Inc Past Accepting new patients

Locations

12171 SW 268th St
Homestead, FL 33032
Phone 30527802001020

11255 SW 211th St
Miami, FL 33189
Phone (305) 254-7576

Organizations & group practices 3

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": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1386360709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12171 SW 268TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330328001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12171 SW 268TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330328001",
            "telephone_number": "305-278-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ REGALADO",
        "first_name": "ERNESTO",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11022452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.