Individual provider Active NPI

Araly Alexis Kelly, FNP

  • Nurse Practitioner
  • Miramar, FL
National Provider Identifier
1427647403
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
12200392 Issued in FL
Practice address
1951 SW 172ND Ave Ste 205
Miramar, FL 33029-5613
Phone
(954) 447-5206
NPI assigned
Jan 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 12200392 FL Primary

Addresses

Primary practice location

1951 SW 172ND Ave Ste 205
Miramar, FL 33029-5613

Mailing address

1951 SW 172ND Ave Ste 314
Miramar, FL 33029-5614
Phone (954) 444-7520

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
I20211208001226 FL Practitioner - Nurse Practitioner 1759771611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.12 of 100Reported as group
Quality
71.03
Promoting interoperability
100
Improvement activities
40
Cost
83.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12200392FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Water Pain Solutions, PA CurrentSince Oct 1, 2024 Accepting new patients

Locations

2 Oakwood Blvd
Ste 195
Hollywood, FL 33020
Phone (305) 459-3410

1951 SW 172nd Ave
Ste 205
Miramar, FL 33029
Phone (954) 442-5191

1951 SW 172nd Ave
Ste 314
Miramar, FL 33029
Phone (549) 447-5206

2010 NW 150th Ave
Ste 100
Pembroke Pines, FL 33028
Phone (754) 264-8779

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": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1427647403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 SW 172ND AVE STE 314",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295614",
            "telephone_number": "954-444-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 SW 172ND AVE STE 205",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295613",
            "telephone_number": "954-447-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ARALY",
        "middle_name": "ALEXIS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "12200392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.