Active NPI
Marie Denise Metellus
- Family Nurse Practitioner
- Miramar, FL
National Provider Identifier
1669877239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- ARNP9235768
- Practice address
- 2065 SW 166TH Ave
Miramar, FL 33027-4492 - Phone
- (954) 609-5043
- NPI assigned
- Oct 25, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | ARNP9235768 | FL | Primary |
Addresses
Primary practice location
2065 SW 166TH Ave
Miramar, FL 33027-4492
Mailing address
2065 SW 166TH Ave
Miramar, FL 33027-4492
Phone (954) 609-5043
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220112000708 | FL | Practitioner - Nurse Practitioner | 6800188996 | Reassigns benefits to 3 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Better Care of Broward Medical Center Inc | Current | Accepting new patients | |
| Rmed LLC | Current | Accepting new patients | |
| Rmed LLC | Current | Accepting new patients |
Locations
8600 Hidden River Pkwy
Ste 75
Tampa, FL 33637
Phone (813) 517-0137
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Dania, FL
- NPI 1295059079
-
- Family Medicine Physician
- Jacksonville, FL
- NPI 1205476793
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414195200000",
"number": "1669877239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2065 SW 166TH AVE",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330274492",
"telephone_number": "954-609-5043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2065 SW 166TH AVE",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330274492",
"telephone_number": "954-609-5043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "METELLUS",
"first_name": "MARIE DENISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-25",
"last_updated": "2014-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "ARNP9235768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.