NPIMap

Individual provider Active NPI

Jaime T Santiago Lopetegui, MD

  • Obstetrics & Gynecology Physician
  • Miami, FL
National Provider Identifier
1669496949
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME70475 Issued in FL
Practice address
1611 NW 12TH Ave
Box 016960 M851
Miami, FL 33101-6960
Phone
(305) 243-4029
Fax
(305) 243-8470
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME70475 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Box 016960 M851
Miami, FL 33101-6960

Mailing address

1611 NW 12TH Ave
Box 016960 M851
Miami, FL 33101-6960
Phone (305) 243-4029

Other identifiers 1

IdentifierTypeStateIssuer
2516926-00MedicaidFL

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
I20100923001179 FL Practitioner - Obstetrics/Gynecology 5395861603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Health Trust of Miami Dade County FloridaGroup PAC ID 0244380434, 469 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Jackson Health System Hospital, Miami, FL, CCN 100022

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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida CurrentSince Jul 10, 2017 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Jul 10, 2017 Accepting new patients

Locations

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

971 NW 2nd St
Miami, FL 33128
Phone (305) 545-5180

1611 NW 12th Ave
#16960
Miami, FL 33136
Phone (305) 243-6358

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1669496949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "BOX 016960 M851",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331016960",
            "telephone_number": "305-243-4029",
            "fax_number": "305-243-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "BOX 016960 M851",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331016960",
            "telephone_number": "305-243-4029",
            "fax_number": "305-243-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO LOPETEGUI",
        "first_name": "JAIME",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME70475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2516926-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.