Individual provider Active NPI

Jorge Alexis Carvajal Ortiz, APRN

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1568033892
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11013604 Issued in FL
Practice address
1479 NW 27TH Ave
Miami, FL 33125-2133
Phone
(305) 423-4044
NPI assigned
Jul 7, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11013604 FL Primary

Addresses

Primary practice location

1479 NW 27TH Ave
Miami, FL 33125-2133

Mailing address

1479 NW 27TH Ave
Miami, FL 33125-2133
Phone (305) 423-4044

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
I20210901001111 FL Practitioner - Nurse Practitioner 5597161414 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Las Mercedes, LLC CurrentSince Aug 18, 2021 Accepting new patients
Clinica Las Mercedes, LLC Current Accepting new patients
Clinica Las Mercedes, LLC CurrentSince Aug 18, 2021 Accepting new patients

Locations

1479 NW 27th Ave
Miami, FL 33125
Phone (305) 633-3776

6355 NW 36th St
Ste 1100
Virginia Gardens, FL 33166

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1568033892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1479 NW 27TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331252133",
            "telephone_number": "305-423-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1479 NW 27TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331252133",
            "telephone_number": "305-423-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARVAJAL ORTIZ",
        "first_name": "JORGE",
        "middle_name": "ALEXIS",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-07",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11013604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.