Individual provider Active NPI

Raul David Elias-Reyes, ARNP

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1710660220
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11023983 Issued in FL
Practice address
955 NW 3Rd St
Miami, FL 33128-1274
Phone
(305) 548-4020
Fax
(305) 777-7200
NPI assigned
Aug 10, 2023
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11023983 FL Primary
Registered Nurse 163W00000X RN9563057 FL

Addresses

Primary practice location

955 NW 3Rd St
Miami, FL 33128-1274

Mailing address

955 NW 3Rd St
Miami, FL 33128-1274
Phone (305) 548-4020

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
I20260622000928 FL Practitioner - Nurse Practitioner 2769955822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2150 Coral Way
FL 2
Miami, FL 33145-2629

955 NW 3Rd St
Miami, FL 33128-1274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9563057FLMDRegistered Nurse
APRN11023983FLMDFamily Nurse Practitioner

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": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1710660220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 NW 3RD ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331281274",
            "telephone_number": "305-548-4020",
            "fax_number": "305-777-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 NW 3RD ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331281274",
            "telephone_number": "305-548-4020",
            "fax_number": "305-777-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIAS-REYES",
        "first_name": "RAUL",
        "middle_name": "DAVID",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11023983",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9563057",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.