Individual provider Active NPI

Angel Jesus Pena Fernandez, ARNP

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1700418662
Registry record updated Feb 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F01201535 Issued in FL
Practice address
18212 SW 144TH CT
Miami, FL 33177-3317
Phone
(305) 896-8967
NPI assigned
Feb 9, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X F01201535 FL Primary

Addresses

Primary practice location

18212 SW 144TH CT
Miami, FL 33177-3317

Mailing address

18212 SW 144TH CT
Miami, FL 33177-3317
Phone (305) 896-8967

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
I20220428001745 FL Practitioner - Nurse Practitioner 9133516784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Palliative Care Services IncGroup PAC ID 7416189998, 16 clinicians

Practice addresses (Care Compare)

14875 NW 77TH Ave
Suite 100
Miami Lakes, FL 33014-2568
Phone (305) 351-7057

3663 S Miami Ave
HCA Florida Mercy Hospital
Miami, FL 33133-4253
Phone (305) 854-4400

Hospital & facility affiliations

  • HCA Florida Mercy Hospital Hospital, Plantation, FL, CCN 100167

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.25
Improvement activities
40
Cost
82.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F01201535FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Palliative Care Services, Inc. Single Specialty CurrentSince Mar 14, 2022 Accepting new patients

Locations

3487 NW 30th St
Lauderdale Lakes, FL 33311
Phone (954) 641-4200

14875 NW 77th Ave
Ste 100
Miami Lakes, FL 33014
Phone (305) 351-7057

14875 NW 77th Ave
Ste 201
Miami Lakes, FL 33014
Phone (305) 351-7086

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1581206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581206400000",
    "number": "1700418662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18212 SW 144TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331773317",
            "telephone_number": "305-896-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18212 SW 144TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331773317",
            "telephone_number": "305-896-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA FERNANDEZ",
        "first_name": "ANGEL",
        "middle_name": "JESUS",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-09",
        "last_updated": "2020-02-09",
        "certification_date": "2020-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F01201535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.