Individual provider Active NPI

Jorge Vito Lastayo, PA-C

  • Surgical Physician Assistant
  • Miami, FL
National Provider Identifier
1437600913
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9109821 Issued in FL
Practice address
8900 N Kendall Dr
Miami, FL 33176-2118
Phone
(786) 596-2000
NPI assigned
Oct 19, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9109821 FL Primary

Addresses

Primary practice location

8900 N Kendall Dr
Miami, FL 33176-2118

Mailing address

PO Box 743144
Atlanta, GA 30374-3144

Other practice location 1

8900 N Kendall Dr
Miami, FL 33176-2118
Phone (786) 596-2000 ext. 77966

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jor01734@cerner.directbaptisthealth.com

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
I20180123001579 FL Practitioner - Physician Assistant 7214296110 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8900 N Kendall Dr
Miami, FL 33176-2118
Phone (786) 596-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.59 of 100Reported as group
Quality
72.23
Promoting interoperability
99
Improvement activities
40
Cost
77.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109821FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Oncology LLC CurrentSince Dec 29, 2019 Accepting new patients

Locations

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

6200 SW 73rd St
South Miami, FL 33143
Phone (305) 661-4611

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.

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": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1437600913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743144",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 N KENDALL DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762118",
            "telephone_number": "786-596-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 N Kendall Dr",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331762118",
            "country_code": "US",
            "telephone_number": "786-596-2000 x77966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASTAYO",
        "first_name": "JORGE",
        "middle_name": "VITO",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-19",
        "last_updated": "2022-02-10",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9109821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jor01734@cerner.directbaptisthealth.com",
            "affiliation": "N",
            "address_1": "8900 N Kendall Dr",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331762118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.