Individual provider Active NPI

Yadian Santiesteban Leyva

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1669057477
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11011989 Issued in FL
Practice address
9611 SW 40TH St
Miami, FL 33165-4030
Phone
(788) 622-3960
Fax
(447) 888-4001
NPI assigned
Mar 12, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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 11011989 FL Primary

Addresses

Primary practice location

9611 SW 40TH St
Miami, FL 33165-4030

Mailing address

9611 SW 40TH St
Miami, FL 33165-4030
Phone (786) 622-3960

Other practice location 1

3824 W 12th Ave
Hialeah, FL 33012-4127
Phone (786) 622-3960

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
I20211102001075 FL Practitioner - Nurse Practitioner 4981092400 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11011989FLMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1615507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1669057477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9611 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331654030",
            "telephone_number": "786-622-3960",
            "fax_number": "447-888-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9611 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331654030",
            "telephone_number": "788-622-3960",
            "fax_number": "447-888-4001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3824 W 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330124127",
            "country_code": "US",
            "telephone_number": "786-622-3960",
            "fax_number": "447-888-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIESTEBAN LEYVA",
        "first_name": "YADIAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-12",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11011989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.