Individual provider Active NPI

Yisel Neyra Fajardo, NP

  • Family Nurse Practitioner
  • Homestead, FL
National Provider Identifier
1679145932
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11011404 Issued in FL
Practice address
15300 SW 288TH St
Homestead, FL 33033-1355
Phone
(305) 224-6402
Fax
(305) 628-8345
NPI assigned
Jul 15, 2021
Last updated
May 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 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 APRN11011404 FL Primary

Addresses

Primary practice location

15300 SW 288TH St
Homestead, FL 33033-1355

Mailing address

8751 SW 38TH St
Miami, FL 33165-5457
Phone (502) 810-4249

Other practice location 1

10300 SW 216th St
Cutler Bay, FL 33190-1003
Phone (305) 253-5100

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
I20250606000074 FL Practitioner - Nurse Practitioner 1355851635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

19033 SW 133Rd Ave
Miami, FL 33177-6271

6950 SE 88TH St
Ocala, FL 34472-3495

8751 SW 38TH St
Miami, FL 33165-5457

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeway Programs Inc CurrentSince May 1, 2025 Accepting new patients

Locations

15300 SW 288th St
Homestead, FL 33033
Phone (305) 224-6402

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1679145932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8751 SW 38TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331655457",
            "telephone_number": "502-810-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 SW 288TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330331355",
            "telephone_number": "305-224-6402",
            "fax_number": "305-628-8345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10300 SW 216th St",
            "address_purpose": "LOCATION",
            "city": "Cutler Bay",
            "state": "FL",
            "postal_code": "331901003",
            "country_code": "US",
            "telephone_number": "305-253-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "YISEL",
        "middle_name": "NEYRA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11011404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.