Individual provider Active NPI

Javier Puentes

  • General Practice Physician
  • Hialeah, FL
National Provider Identifier
1679946982
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN806 Issued in FL
Practice address
5341 W 20TH Ave
Hialeah, FL 33012-2100
Phone
(786) 261-3762
NPI assigned
Nov 9, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN806 FL Primary
General Practice Physician 208D00000X 019206 PR

Addresses

Primary practice location

5341 W 20TH Ave
Hialeah, FL 33012-2100

Mailing address

5341 W 20TH Ave
Hialeah, FL 33012-2100
Phone (786) 261-3762

Other practice location 1

3919 Ave Isla Verde
Cond Reef Tower Apt 7-E
Carolina, PR 00979-6717
Phone (786) 261-3762

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180329000313 FL Practitioner - General Practice 5698077568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5341 W 20TH Ave
Hialeah, FL 33012-2100
Phone (786) 542-1882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
019206PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Javier Puentes PA General Practice CurrentSince Feb 15, 2018 Accepting new patients
Oracle Health Systems Inc CurrentSince Jan 16, 2018 Accepting new patients

Locations

5341 W 20th Ave
Hialeah, FL 33012
Phone (305) 850-7874

7031 SW 62nd Ave
South Miami, FL 33143
Phone (305) 284-7585

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.

NPI Registry JSON

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1679946982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5341 W 20TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330122100",
            "telephone_number": "786-261-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5341 W 20TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330122100",
            "telephone_number": "786-261-3762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3919 Ave Isla Verde",
            "address_2": "Cond Reef Tower Apt 7-E",
            "address_purpose": "LOCATION",
            "city": "Carolina",
            "state": "PR",
            "postal_code": "009796717",
            "country_code": "US",
            "telephone_number": "786-261-3762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUENTES",
        "first_name": "JAVIER",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-09",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN806",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "019206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.