NPIMap

Individual provider Active NPI

Gwendolyn Castaneda

  • Certified Registered Nurse Anesthetist
  • Miami, FL
National Provider Identifier
1720670920
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11011164 Issued in FL
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1005
Phone
(305) 467-8512
NPI assigned
Feb 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 11011164 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1005

Mailing address

18321 NW 79TH CT
Hialeah, FL 33015-2706
Phone (305) 467-8512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210318001969 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315354362 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Health Trust of Miami Dade County FloridaGroup PAC ID 0244380434, 469 clinicians

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-1111

Hospital & facility affiliations

  • Jackson Health System Hospital, Miami, FL, CCN 100022

Merit-based Incentive Payment System (MIPS)

Final score
91.01 of 100Reported as group
Quality
72.99
Promoting interoperability
82
Improvement activities
40
Cost
78.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11011164FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida CurrentSince Apr 26, 2021 Accepting new patients
Anesthesia Associates of Greater Miami, PA CurrentSince Jan 28, 2026 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Apr 26, 2021 Accepting new patients

Locations

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

9333 SW 152nd St
Palmetto Bay, FL 33157
Phone (305) 251-2500

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 3

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1720670920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18321 NW 79TH CT",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330152706",
            "telephone_number": "305-467-8512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-467-8512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTANEDA",
        "first_name": "GWENDOLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11011164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.