Individual provider Active NPI

Jessica Telleria-Cano, MD

  • Diagnostic Radiology Physician
  • South Miami, FL
National Provider Identifier
1407387558
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME156330 Issued in FL
Practice address
7000 SW 62ND Avenue
Suite 600
South Miami, FL 33143-4728
Phone
(305) 284-7577
Fax
(305) 284-7688
NPI assigned
Mar 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME156330 FL Primary

Addresses

Primary practice location

7000 SW 62ND Avenue
Suite 600
South Miami, FL 33143-4728

Mailing address

9220 SW 101St St
Miami, FL 33176-3039
Phone (305) 322-4864

Other practice location 1

1435 W 49th Place
Suite 402
Hialeah, FL 33012-3147
Phone (305) 907-8526

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
I20221116000832 FL Practitioner - Diagnostic RadiologyPractitioner - Other (Physician) 1850648445 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Florida International Univ, College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Multispecialty Medical Services LLCGroup PAC ID 1850558842, 11 clinicians
Leon Medical Centers LLCGroup PAC ID 9537066618, 108 clinicians

Practice addresses (Care Compare)

7000 SW 62 Ave
Suite 600
South Miami, FL 33143-4721
Phone (305) 284-7700

7950 NW 2ND St
Miami, FL 33126-8017
Phone (305) 907-4147

Hospital & facility affiliations

  • Larkin Community Hospital Hospital, South Miami, FL, CCN 100181

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Leon Medical Centers LLC CurrentSince Oct 11, 2022 Accepting new patients
Advanced Multispecialty Medical Services LLC CurrentSince Sep 23, 2024 Accepting new patients
Cira Michigan PC Diagnostic Radiology Past Accepting new patients

Locations

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

1435 W 49th Pl
Ste 402
Hialeah, FL 33012
Phone (305) 907-8526

1475 W 49th St
Hialeah, FL 33012
Phone (305) 824-4761

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

7950 NW 2nd St
Miami, FL 33126
Phone (305) 552-8822

5996 SW 70th St
Fl 3
South Miami, FL 33143

7031 SW 62nd Ave
South Miami, FL 33143
Phone (305) 284-7585

7000 SW 62nd Ave
Ste 600
South Miami, FL 33143
Phone (305) 284-7577

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1407387558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9220 SW 101ST ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331763039",
            "telephone_number": "305-322-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 SW 62ND AVENUE",
            "address_2": "SUITE 600",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434728",
            "telephone_number": "305-284-7577",
            "fax_number": "305-284-7688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1435 W 49th Place",
            "address_2": "Suite 402",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330123147",
            "country_code": "US",
            "telephone_number": "305-907-8526",
            "fax_number": "305-907-0228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TELLERIA-CANO",
        "first_name": "JESSICA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME156330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.