Individual provider Active NPI

Nicole Danielle A Yee-Nicholson, PSY.D

  • Clinical Psychologist
  • Miramar, FL
National Provider Identifier
1649083262
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY12584 Issued in FL
Practice address
2281 SW 129TH Ave
Miramar, FL 33027-2652
Phone
(954) 998-6535
NPI assigned
Jan 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY12584 FL Primary

Addresses

Primary practice location

2281 SW 129TH Ave
Miramar, FL 33027-2652

Mailing address

15711 SW 20TH St
Miramar, FL 33027-4204
Phone (954) 707-7753

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250225003998 FL Practitioner - Clinical Psychologist 4385164912 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ricardo Buitrago PSYD PAGroup PAC ID 1658742952, 3 clinicians
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

2281 SW 129TH Ave
Miramar, FL 33027-2652
Phone (516) 286-8909

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY12584FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA CurrentSince Jun 20, 2025 Accepting new patients
Ricardo Buitrago PSYD PA Clinical CurrentSince Jan 28, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1738022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1649083262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15711 SW 20TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274204",
            "telephone_number": "954-707-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2281 SW 129TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330272652",
            "telephone_number": "954-998-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEE-NICHOLSON",
        "first_name": "NICOLE DANIELLE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY12584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.