Individual provider Active NPI

Marie Ketty Jussome, ARNP-C

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1417374083
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9340018 Issued in FL
Practice address
1240 NW 119TH St
Miami, FL 33167-3232
Phone
(305) 685-5688
Fax
(786) 761-1263
NPI assigned
Mar 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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 ARNP9340018 FL Primary

Addresses

Primary practice location

1240 NW 119TH St
Miami, FL 33167-3232

Mailing address

8333 NW 53Rd St FL 6
Doral, FL 33166-4783

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140509001284 FL Practitioner - Nurse Practitioner 5395978779 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cano Health, LLC CurrentSince Jan 3, 2022 Accepting new patients

Locations

368 E Dania Beach Blvd
Dania Beach, FL 33004
Phone 3055865688 ext. 2190

8333 NW 53rd St
Fl 6
Doral, FL 33166

5605 NW 82nd Ave
Doral, FL 33166
Phone (305) 777-3515

9725 NW 117th Ave
Ste 200
Medley, FL 33178
Phone 9545149360 ext. 8515

1240 NW 119th St
Miami, FL 33167
Phone 3056855688 ext. 1190

1272 NW 119th St
Miami, FL 33167
Phone (407) 219-6087

12600 SW 120th St
Ste 101
Miami, FL 33186
Phone (305) 506-1930

4888 NW 183rd St
Ste 101
Miami Gardens, FL 33055
Phone 3056855688 ext. 1290

5190 NW 167th St
Ste 109
Miami Lakes, FL 33014
Phone (305) 384-6450

20215 NW 2nd Ave
Ste 1
North Miami Beach, FL 33169
Phone (305) 652-4542

680 N University Dr
Pembroke Pines, FL 33024
Phone (954) 538-6868

Interoperability endpoints

  • Direct secure messaging: marie.jussome@chealth.eclinicaldirectplus.com

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, 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": "1395360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1417374083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 NW 53RD ST FL 6",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331664783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 NW 119TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331673232",
            "telephone_number": "305-685-5688",
            "fax_number": "786-761-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSSOME",
        "first_name": "MARIE",
        "middle_name": "KETTY",
        "credential": "ARNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-21",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9340018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.