Individual provider Active NPI

Kariesa Ambalika Brown

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1396306841
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME155712 Issued in FL
Practice address
2230 NW 95TH St
Miami, FL 33147-2414
Phone
(305) 827-2977
Fax
(305) 820-6374
NPI assigned
Jun 25, 2019
Last updated
Mar 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME155712 FL Primary

Addresses

Primary practice location

2230 NW 95TH St
Miami, FL 33147-2414

Mailing address

2230 NW 95TH St
Miami, FL 33147-2414
Phone (305) 827-2977

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
I20220329002993 FL Practitioner - Family Practice 0941696082 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME155712FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chen Neighborhood Medical Centers of South Florida LLC CurrentSince Mar 27, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kbrown17514@prd.direct.tbh.org

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": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1396306841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 NW 95TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331472414",
            "telephone_number": "305-827-2977",
            "fax_number": "305-820-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 NW 95TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331472414",
            "telephone_number": "305-827-2977",
            "fax_number": "305-820-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KARIESA",
        "middle_name": "AMBALIKA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME155712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.