NPIMap

Individual provider Active NPI

Miguel Angel Telleria, M.D., M.B.A.

  • Anesthesiology Physician
  • Miami, FL
National Provider Identifier
1467614636
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME121707 Issued in FL
Practice address
8501 SW 124TH Ave Ste 110
Miami, FL 33183-4631
Phone
(786) 808-8555
Fax
(786) 360-1100
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME121707 FL Primary
Interventional Pain Medicine Physician 208VP0014X ME121707 FL

Addresses

Primary practice location

8501 SW 124TH Ave Ste 110
Miami, FL 33183-4631

Mailing address

9066 SW 73Rd CT PH 2404
Pinecrest, FL 33156-2972
Phone (786) 808-8555

Other practice location 1

7791 NW 146th St
Miami Lakes, FL 33016-1567
Phone (786) 808-8555

Other identifiers 1

IdentifierTypeStateIssuer
015575800MedicaidFL

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
I20150803000338 FL Practitioner - AnesthesiologyPractitioner - Pain Management 5698096394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
University of Miami, LM Miller School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Matmed LLCGroup PAC ID 5193052249, 13 clinicians

Practice addresses (Care Compare)

925 NE 30TH Ter
Suite 314
Homestead, FL 33033-7614
Phone (786) 808-8555

Hospital & facility affiliations

  • Jackson Health System Hospital, Miami, FL, CCN 100022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Matmed LLC Interventional Pain Medicine CurrentSince Jun 15, 2019 Accepting new patients
Matmed LLC Interventional Pain Medicine Past Accepting new patients
Matmed LLC Interventional Pain Medicine Past Accepting new patients
Matmed Interventional Pain Medicine Past Accepting new patients
Matmed LLC PastSince Jun 25, 2023 Accepting new patients
Matmed LLC Interventional Pain Medicine Past Accepting new patients
Matmed LLC Interventional Pain Medicine Past Accepting new patients
Matmed LLC Interventional Pain Medicine Past Accepting new patients

Locations

2020 Ponce de Leon Blvd
Ste 103
Coral Gables, FL 33134
Phone (305) 224-8850

925 NE 30th Ter
Ste 314
Homestead, FL 33033
Phone (786) 243-2950

7791 NW 146 St
Miami, FL 33106

8501 SW 124th Ave
Ste 110
Miami, FL 33183
Phone (786) 808-8555

7791 NW 146th St
Miami Lakes, FL 33016
Phone (786) 808-8555

10967 Lake Underhill Rd
Ste 107
Orlando, FL 32825
Phone (321) 306-6014

300 NW 70th Ave
Ste 102
Plantation, FL 33317
Phone (786) 808-8555

13302 Winding Oak Ct
Ste A
Tampa, FL 33612
Phone (786) 808-8555

Interoperability endpoints

  • Direct secure messaging: telleria.miguel.p1@direct.caremax.nextgenshare.com
  • Direct secure messaging: miguel.telleria.d1.p1@direct.caremax.nextgenshare.com

Organizations & group practices 8

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": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1467614636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9066 SW 73RD CT PH 2404",
            "city": "PINECREST",
            "state": "FL",
            "postal_code": "331562972",
            "telephone_number": "786-808-8555",
            "fax_number": "786-360-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 SW 124TH AVE STE 110",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331834631",
            "telephone_number": "786-808-8555",
            "fax_number": "786-360-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7791 NW 146th St",
            "address_purpose": "LOCATION",
            "city": "Miami Lakes",
            "state": "FL",
            "postal_code": "330161567",
            "country_code": "US",
            "telephone_number": "786-808-8555",
            "fax_number": "305-967-8497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TELLERIA",
        "first_name": "MIGUEL",
        "middle_name": "ANGEL",
        "credential": "M.D., M.B.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME121707",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME121707",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015575800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.