Individual provider Active NPI

Teresa Graciela Bueno, ARNP

  • Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1457433609
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2691882 Issued in FL
Practice address
1150 N 35TH Ave
Suite 135
Hollywood, FL 33021-5424
Phone
(954) 265-7750
Fax
(954) 893-6518
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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 2691882 FL Primary

Addresses

Primary practice location

1150 N 35TH Ave
Suite 135
Hollywood, FL 33021-5424

Mailing address

2900 Corporate Way
MPG Door D
Miramar, FL 33025-3925
Phone (954) 276-5581

Other identifiers 1

IdentifierTypeStateIssuer
009326700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tbueno112657@MHSDIRECT.NET Direct

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
I20130920000374 FL Practitioner - Nurse Practitioner 4385888932 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, shared by 55 NPIs, 659 clinicians

Practice addresses (Care Compare)

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-7750

Hospital & facility affiliations

  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2691882FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince May 20, 2014 Accepting new patients
South Broward Hospital District CurrentSince May 20, 2014 Accepting new patients
South Broward Hospital District CurrentSince Sep 15, 2020 Accepting new patients
South Broward Hospital District CurrentSince May 20, 2014 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

1150 N 35th Ave
Ste 135
Hollywood, FL 33021
Phone (954) 265-6989

3501 Johnson St
Fl 1
Hollywood, FL 33021
Phone (954) 265-7750

1150 N 35th Ave
Ste 605
Hollywood, FL 33021
Phone (954) 965-2966

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

4651 Sheridan St
Ste 150
Pembroke Park, FL 33021
Phone (954) 265-6331

801 N Flamingo Rd
Pembroke Pines, FL 33028
Phone (954) 844-6868

Interoperability endpoints

  • Direct secure messaging: tbueno112657@mhsdirect.net

Organizations & group practices 5

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 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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1457433609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "MPG DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5581",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE",
            "address_2": "SUITE 135",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215424",
            "telephone_number": "954-265-7750",
            "fax_number": "954-893-6518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUENO",
        "first_name": "TERESA",
        "middle_name": "GRACIELA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "2691882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009326700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbueno112657@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1150 N 35th Ave",
            "address_2": "Suite 135",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.