Individual provider Active NPI

Jessica Justiniano

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1598327850
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11000293 Issued in FL
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1005
Phone
(305) 585-1111
NPI assigned
Jul 7, 2019
Last updated
Feb 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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 11000293 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1005

Mailing address

14511 SW 138TH PL
Miami, FL 33186-7215
Phone (786) 466-8484

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
I20191030003633 FL Practitioner - Nurse Practitioner 5890027445 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.01 of 100Reported as group
Quality
72.99
Promoting interoperability
82
Improvement activities
40
Cost
78.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11000293FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida CurrentSince May 11, 2020 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince May 11, 2020 Accepting new patients
Miami Jewish Health Systems, Inc. CurrentSince Sep 10, 2019 Accepting new patients
Public Health Trust of Dade County Florida Past Accepting new patients

Locations

3737 SW 8th St
Ste B
Coral Gables, FL 33134
Phone (305) 575-1600

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

1801 NW 9th Ave
Ste 600
Miami, FL 33136
Phone (305) 585-4564

5200 NE 2nd Ave
Miami, FL 33137
Phone (305) 762-1387

9380 SW 150th St
Ste 250
Miami, FL 33176
Phone (305) 256-5030

100 NW 170th St
Ste 410
North Miami Beach, FL 33169
Phone (305) 606-7028

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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": "1562457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1598327850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14511 SW 138TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331867215",
            "telephone_number": "786-466-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTINIANO",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11000293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.