Individual provider Active NPI

Enrique Martin Schubert, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Miami, FL
National Provider Identifier
1447791454
Registry record updated Jul 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
38087 Issued in TX
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1005
Phone
(305) 585-5326
Fax
(305) 256-5208
NPI assigned
Mar 10, 2017
Last updated
Jul 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 38087 TX Primary
Advanced Practice Dental Therapist 125K00000X 00000 FL

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1005

Mailing address

500 NW 36TH St Apt 510
Miami, FL 33127-3146
Phone (305) 799-7275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20221214002859 TX Practitioner - Maxillofacial SurgeryPractitioner - Dentist 4284003203 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00000FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Umc El Paso Healthcare Inc CurrentSince Nov 1, 2022 Accepting new patients

Locations

1400 Hardaway St
El Paso, TX 79903

4500 N Mesa St
El Paso, TX 79912
Phone (915) 532-9000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24611/brand/1/csg/1/fhir/r4

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": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658534400000",
    "number": "1447791454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NW 36TH ST APT 510",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331273146",
            "telephone_number": "305-799-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-5326",
            "fax_number": "305-256-5208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUBERT",
        "first_name": "ENRIQUE",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-10",
        "last_updated": "2022-07-23",
        "certification_date": "2022-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "38087",
            "primary": true
        },
        {
            "code": "125K00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Dental Therapist",
            "state": "FL",
            "license": "00000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.