Active NPI
Irene Roldan
- Family Nurse Practitioner
- Miami, FL
National Provider Identifier
1629545330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN11000028
- Practice address
- 15971 SW 138 Ter
Miami, FL 33196 - Phone
- (786) 623-8617
- NPI assigned
- Oct 31, 2018
- Last updated
- Oct 31, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11000028 | FL | Primary |
Addresses
Primary practice location
15971 SW 138 Ter
Miami, FL 33196
Mailing address
15971 SW 138TH Ter
Miami, FL 33196-6439
Phone (786) 623-8617
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231201002261 | FL | Order and Referring Only - Nurse Practitioner | 7810345733 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11000028 | FL | MD | Family Nurse Practitioner |
Interoperability endpoints
- iroldan@ucsf.gwaydirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540944000000",
"number": "1629545330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15971 SW 138TH TER",
"city": "MIAMI",
"state": "FL",
"postal_code": "331966439",
"telephone_number": "786-623-8617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15971 SW 138 TER",
"city": "MIAMI",
"state": "FL",
"postal_code": "33196",
"telephone_number": "786-623-8617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLDAN",
"first_name": "IRENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-31",
"last_updated": "2018-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11000028",
"primary": true
}
],
"identifiers": [],
"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 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.