Individual provider Active NPI

Miren Alai De Urresti, MD

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1558377382
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0072002 Issued in FL
Practice address
13055 SW 42ND St Ste 108
Miami, FL 33175
Phone
(305) 204-9195
Fax
(305) 204-9196
NPI assigned
Aug 1, 2006
Last updated
Jun 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0072002 FL Primary

Addresses

Primary practice location

13055 SW 42ND St Ste 108
Miami, FL 33175

Mailing address

15475 SW 42ND Ter
Miami, FL 33185-4543
Phone (305) 551-5617

Other identifiers 1

IdentifierTypeStateIssuer
252784700MedicaidFL

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
I20130925000242 FL Practitioner - Family Practice 9032353495 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13055 SW 42ND St
Suite 108
Miami, FL 33175-3409
Phone (305) 204-9195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0072002FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stefano Mion Bet MD PA Family Medicine CurrentSince Jan 26, 2017 Accepting new patients
Criticare Clinics Inc CurrentSince Jul 22, 2013 Accepting new patients

Locations

4741 S University Dr
Davie, FL 33328
Phone (954) 837-1050

13055 SW 42nd St
Ste 108
Miami, FL 33175
Phone (305) 204-9195

14701 NW 77th Ave
Miami Lakes, FL 33014
Phone (305) 669-2833

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIAIBD/Endpoint/AIAIBD

Organizations & group practices 2

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1558377382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15475 SW 42ND TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331854543",
            "telephone_number": "305-551-5617",
            "fax_number": "305-551-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13055 SW 42ND ST STE 108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33175",
            "telephone_number": "305-204-9195",
            "fax_number": "305-204-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE URRESTI",
        "first_name": "MIREN",
        "middle_name": "ALAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0072002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252784700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.