Individual provider Active NPI

Paul James Nieves, M.D.

  • Gastroenterology Physician
  • Doral, FL
National Provider Identifier
1386687044
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME126076 Issued in FL
Practice address
8600 NW 41St St
Doral, FL 33166-6202
Phone
(305) 642-5366
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 15952 PR
Gastroenterology Physician 207RG0100X 15952 PR
Gastroenterology Physician 207RG0100X ME126076 FL Primary

Addresses

Primary practice location

8600 NW 41St St
Doral, FL 33166-6202

Mailing address

10297 NW 75TH Ter
Doral, FL 33178-3394
Phone (305) 642-5366

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250225000584 FL Practitioner - Gastroenterology 8325182322 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME126076FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Leon Medical Centers LLC CurrentSince Oct 8, 2024 Accepting new patients

Locations

8600 NW 41st St
Doral, FL 33166
Phone (305) 642-1511

11501 SW 40th St
Miami, FL 33165
Phone (305) 646-3716

Organizations & group practices 1

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1386687044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10297 NW 75TH TER",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331783394",
            "telephone_number": "305-642-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 NW 41ST ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666202",
            "telephone_number": "305-642-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES",
        "first_name": "PAUL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "15952",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PR",
            "license": "15952",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME126076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.