Individual provider Active NPI

Dalissa Marie Tejera

  • Nurse Practitioner
  • Miami, FL
National Provider Identifier
1558706424
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9288695 Issued in FL
Practice address
1475 NW 12TH Ave
Miami, FL 33136-1002
Phone
(305) 243-9136
NPI assigned
May 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 9288695 FL
Nurse Practitioner 363L00000X ARNP9288695 FL Primary

Addresses

Primary practice location

1475 NW 12TH Ave
Miami, FL 33136-1002

Mailing address

1475 NW 12TH Ave
Miami, FL 33136-1002
Phone (305) 243-9136

Other identifiers 5

IdentifierTypeStateIssuer
4668245OtherFLAETNA
QMP000003701324OtherFLMOLINA HEALTHCARE
P1008781OtherFLFREEDOM HEALTH
Y0J0DOtherFLBCBS OF FL
P948501OtherFLOPTIMUM

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
I20130819000283 FL Practitioner - Nurse Practitioner 2961644133 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

1475 NW 12TH
1 Umhc SCCC
Miami, FL 33136-1002
Phone (305) 243-8434

1475 NW 12TH Ave
Miami, FL 33136-1002

1475 NW 12TH Ave 1St FL
Miami, FL 33136-1002

1475 NW 12TH Ave 1St FLR
Miami, FL 33136-1002

1475 NW 12TH Ave 3Rd Floor
Umhc SCCC
Miami, FL 33136-1002
Phone (305) 243-8644

1475 NW 12TH Ave 4TH FLR Stem Cell
Umhc SCCC
Miami, FL 33136-1002
Phone (954) 831-2763

1475 NW 12TH Ave C
130 Umhc SCCC Alex's Place
Miami, FL 33136-1002
Phone (305) 243-6857

1475 NW 12TH Ave Courtelis Ctr
C021 Umhc SCCC
Miami, FL 33136-1002
Phone (305) 243-6387

1475 NW 12TH Ave Head and Neck Clinic
Umhc SCCC
Miami, FL 33136-1002
Phone (305) 585-7890

1475 NW 12TH Ave Opd
Umhc SCCC
Miami, FL 33136-1002
Phone (954) 493-8666

1601 NW 12TH Ave
Miami, FL 33136-1005

1601 NW 12TH Ave 1St FL
Miami, FL 33136-1005

1601 NW 12TH Ave 1St FLR
Miami, FL 33136-1005

1601 NW 12TH Ave Room
2060 MCCD
Miami, FL 33136-1005
Phone (305) 585-5635

1601 NW 12TH Avenue 5065 /
5TH Mailman Center for Child Development
Miami, FL 33136-1005
Phone (305) 243-6251

1611 NW 12 Ave
Miami, FL 33136-1005

1611 NW 12 TH Ave
Jackson Memorial Hospital
Miami, FL 33136-1005
Phone (305) 355-5000

1611 NW 12TH
3B Jackson Memorial Hospital Acc West
Miami, FL 33136-1005
Phone (305) 585-7476

1611 NW 12TH Ave 2ND FL
Miami, FL 33136-1005

1611 NW 12TH Ave 2ND FLR
Miami, FL 33136-1005

1611 NW 12TH Ave 5TH Floor
Acc Clinic West JMH
Miami, FL 33136-1005
Phone (305) 243-4211

1611 NW 12TH Ave Acc E
Miami, FL 33136-1005

1611 NW 12TH Ave Acc E 2ND FLR
Miami, FL 33136-1005

1611 NW 12TH Ave Acc W
Miami, FL 33136-1005

1611 NW 12TH Ave Acc West
Miami, FL 33136-1005

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
78.79
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9288695FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
Baptist Health Medical Group Oncology LLC CurrentSince Dec 27, 2017 Accepting new patients
University of Miami Nurse Practitioner CurrentSince Jan 1, 2020 Accepting new patients
Baptist Health Medical Group Oncology LLC CurrentSince Dec 27, 2017 Accepting new patients
University of Miami Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1475 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4200

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1475 NW 12th Ave
Fl 3
Miami, FL 33136
Phone (305) 243-2363

1475 NW 12th Ave
Fl 2
Miami, FL 33136
Phone (305) 243-4902

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1558706424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361002",
            "telephone_number": "305-243-9136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361002",
            "telephone_number": "305-243-9136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJERA",
        "first_name": "DALISSA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-06",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9288695",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9288695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4668245",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA HEALTHCARE",
            "identifier": "QMP000003701324",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM HEALTH",
            "identifier": "P1008781",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "Y0J0D",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "P948501",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.