Individual provider Active NPI

Jose I Del Risco

  • Family Nurse Practitioner
  • Doral, FL
National Provider Identifier
1639773377
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11010383 Issued in FL
Practice address
10450 NW 33Rd St Unit 205
Doral, FL 33172-1005
Phone
(786) 206-3155
Fax
(786) 772-2009
NPI assigned
Nov 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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 APRN11010383 FL Primary

Addresses

Primary practice location

10450 NW 33Rd St Unit 205
Doral, FL 33172-1005

Mailing address

8855 NW 180TH Ter
Hialeah, FL 33018-6504
Phone (786) 200-0628

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL jsdelrisco@gmail.com Direct

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
I20210920003542 FL Practitioner - Nurse Practitioner 7517224405 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11010383FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nextlevel Complete Family Care Inc CurrentSince May 18, 2023 Accepting new patients
Ronoel Penalver Mdpa PastSince May 18, 2023 Accepting new patients

Locations

10450 NW 33rd St
Unit 205
Doral, FL 33172
Phone (786) 206-3155

Organizations & group practices 2

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": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1639773377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8855 NW 180TH TER",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330186504",
            "telephone_number": "786-200-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 NW 33RD ST UNIT 205",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331721005",
            "telephone_number": "786-206-3155",
            "fax_number": "786-772-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL RISCO",
        "first_name": "JOSE",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-23",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11010383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jsdelrisco@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8855 NW 180th Ter",
            "city": "Hialeah",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330186504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.