Organization Active NPI

Benessere Medical Institute LLC

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1578288916
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
BENESSERE MEDICAL INSTITUTE LLC
Practice address
790 NW 107TH Ave Ste 301
Miami, FL 33172-3160
Phone
(786) 953-6559
NPI assigned
Oct 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Authorized official

Name
Carlos Diaz, PANPI 1770125098
Title
Part Owner
Phone
(786) 506-1786

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

790 NW 107TH Ave Ste 301
Miami, FL 33172-3160

Mailing address

790 NW 107TH Ave Ste 301
Miami, FL 33172-3160
Phone (786) 953-6559

Other identifiers 1

IdentifierTypeStateIssuer
106809400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230428001605 FL Part B Supplier - Clinic/Group Practice 3173988094 Receives reassigned benefits from 6 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665100800000",
    "number": "1578288916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 NW 107TH AVE STE 301",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331723160",
            "telephone_number": "786-953-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 NW 107TH AVE STE 301",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331723160",
            "telephone_number": "786-953-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENESSERE MEDICAL INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "PART OWNER",
        "authorized_official_telephone_number": "786-506-1786",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106809400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.