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Individual provider Active NPI

Nidia Irene Perez Pereda

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1649738634
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11001575 Issued in FL
Practice address
1611 NW 12TH Ave
West Wing 6TH Floor
Miami, FL 33136-1096
Phone
(305) 440-9010
Fax
(786) 791-7090
NPI assigned
Mar 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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 11001575 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
West Wing 6TH Floor
Miami, FL 33136-1096

Mailing address

4331 SW 159TH Path
Miami, FL 33185-5310
Phone (305) 440-9010

Other practice location 1

4331 SW 159th Path
Miami, FL 33185-5310
Phone (305) 440-9010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200327000179 FL Practitioner - Nurse Practitioner 0345679320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-1111

Hospital & facility affiliations

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
11001575FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida CurrentSince Feb 15, 2020 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Feb 15, 2020 Accepting new patients
NP Care and Wellness LLC Family CurrentSince Sep 8, 2025 Accepting new patients
Public Health Trust of Dade County Florida Past Accepting new patients

Locations

1611 NW 12th Ave
Ste 600B
Miami, FL 33136
Phone (305) 355-1303

1611 NW 12th Ave
Fl 6
Miami, FL 33136
Phone (305) 440-9010

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

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 and National Provider Directory roles.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1552003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1649738634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4331 SW 159TH PATH",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855310",
            "telephone_number": "305-440-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "WEST WING 6TH FLOOR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361096",
            "telephone_number": "305-440-9010",
            "fax_number": "786-791-7090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4331 SW 159th Path",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331855310",
            "country_code": "US",
            "telephone_number": "305-440-9010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ PEREDA",
        "first_name": "NIDIA",
        "middle_name": "IRENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-08",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11001575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.