NPIMap

Individual provider Active NPI

Bethany D Lataillade, APRN

  • Adult Health Nurse Practitioner
  • Miramar, FL
National Provider Identifier
1447897723
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
11003508 Issued in FL
Practice address
13775 SW 31St St
Miramar, FL 33027-3976
Phone
(585) 967-7605
NPI assigned
Dec 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 11003508 FL
Adult Health Nurse Practitioner 363LA2200X 11003508 FL Primary

Addresses

Primary practice location

13775 SW 31St St
Miramar, FL 33027-3976

Mailing address

13775 SW 31St St
Miramar, FL 33027-3976
Phone (585) 967-7605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200619000849 FL Practitioner - Nurse Practitioner 5092137059 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.01 of 100Reported as group
Quality
72.99
Promoting interoperability
82
Improvement activities
40
Cost
78.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11003508FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nchmd Inc Current Accepting new patients
Nchmd, Inc CurrentSince Mar 26, 2024 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Apr 26, 2020 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Apr 26, 2020 Accepting new patients
Landmark Hospital of Southwest Florida, LLC CurrentSince Mar 26, 2024 Accepting new patients
Public Health Trust of Dade County Florida Past Accepting new patients

Locations

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1611 NW 12th Ave
Ste 600B
Miami, FL 33136
Phone (305) 355-1303

11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

311 Tamiami Trl N
Ste 304
Naples, FL 34102
Phone (239) 624-2730

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: blataillade80496@nchhealthcaresystem.direct-ci.com

Organizations & group practices 6

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1447897723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13775 SW 31ST ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330273976",
            "telephone_number": "585-967-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13775 SW 31ST ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330273976",
            "telephone_number": "585-967-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATAILLADE",
        "first_name": "BETHANY",
        "middle_name": "D",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-05",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11003508",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11003508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.