Individual provider Active NPI

Maria J Bertoli Avella, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Miami, FL
National Provider Identifier
1487895504
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME114727 Issued in FL
Practice address
3610 SW 106 Ave
Miami, FL 33165
Phone
(786) 395-4635
NPI assigned
Mar 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME114727 FL Primary

Addresses

Primary practice location

3610 SW 106 Ave
Miami, FL 33165

Mailing address

3610 SW 106TH Ave
Miami, FL 33165-3627
Phone (786) 395-4635

Other names 1

  • Maria J Bertoli Avella Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150121001375 FL Practitioner - Pathology 6103140249 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Regional Laboratories Pathology Services, LLCGroup PAC ID 9133244346, 132 clinicians

Practice addresses (Care Compare)

11750 SW 40 St
Miami, FL 33175-3530
Phone (305) 227-5579

Hospital & facility affiliations

  • HCA Florida Kendall Hospital Hospital, Miami, FL, CCN 100209
  • Lower Keys Medical Center Hospital, Key West, FL, CCN 100150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Raul I Vila MD & Associates PA Anatomic Pathology & Clinical Pathology CurrentSince Mar 12, 2015 Accepting new patients
Integrated Regional Laboratories Pathology Services, LLC Anatomic Pathology & Clinical Pathology CurrentSince Jul 28, 2015 Accepting new patients
Pathmed Associates LLC Anatomic Pathology & Clinical Pathology Current Accepting new patients

Locations

3201 SW 15th St
Deerfield Beach, FL 33442
Phone (954) 246-7625

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

2500 SW 75th Ave
Miami, FL 33155
Phone (305) 431-0577

Organizations & group practices 3

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 2

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": "1237420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1487895504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 SW 106TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653627",
            "telephone_number": "786-395-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 SW 106 AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33165",
            "telephone_number": "786-395-4635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOLI AVELLA",
        "first_name": "MARIA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-19",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME114727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "BERTOLI AVELLA",
            "middle_name": "J",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.