Individual provider Active NPI

Nikelson Pierre, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Homestead, FL
National Provider Identifier
1497480636
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11020922 Issued in FL
Practice address
54 SW 15TH Ter
Homestead, FL 33030-6686
Phone
(786) 339-2528
NPI assigned
Jul 21, 2022
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11020922 FL Primary

Addresses

Primary practice location

54 SW 15TH Ter
Homestead, FL 33030-6686

Mailing address

54 SW 15TH Ter
Homestead, FL 33030-6686
Phone (786) 339-2528

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
I20220907000559 FL Practitioner - Nurse Practitioner 4981088101 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Agape Network, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Dec 30, 2025 Accepting new patients
Excelsior Behavioral Health & Wellness LLC Psychiatric/Mental Health CurrentSince Aug 13, 2025 Accepting new patients
Agape Network, Inc. CurrentSince Sep 1, 2022 Accepting new patients

Locations

22790 SW 112th Ave
Miami, FL 33170
Phone (305) 235-2616

22790 SW 112th Ave
Fl Jail
Miami, FL 33170
Phone (305) 235-2616

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

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": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497480636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 SW 15TH TER",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330306686",
            "telephone_number": "786-339-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 SW 15TH TER",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330306686",
            "telephone_number": "786-339-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE",
        "first_name": "NIKELSON",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11020922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.