NPIMap

Individual provider Active NPI

Marlyn Morejon

  • Acute Care Nurse Practitioner
  • Miami Gardens, FL
National Provider Identifier
1740890466
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
11008143 Issued in FL
Practice address
18574 NW 53Rd Ave
Miami Gardens, FL 33055-5342
Phone
(786) 351-6114
NPI assigned
Aug 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 11008143 FL Primary

Addresses

Primary practice location

18574 NW 53Rd Ave
Miami Gardens, FL 33055-5342

Mailing address

18574 NW 53Rd Ave
Miami Gardens, FL 33055-5342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210921001428 FL Practitioner - Nurse Practitioner 7618374471 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Barry University School of Podiatric Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Grove Physician Services PAGroup PAC ID 8628421526, 65 clinicians

Practice addresses (Care Compare)

160 NW 170 St
North Miami Beach, FL 33169-5521
Phone (305) 651-1100

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11008143FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Accountable Care Hospitalist Group CurrentSince Jun 1, 2024 Accepting new patients
Holistic Aesthetic Wellness Inc Current Accepting new patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Aug 1, 2021 Accepting new patients
Oak Grove Physician Services, P.a. CurrentSince Feb 1, 2024 Accepting new patients
Advance Jackson Home Health Services Current Accepting new patients
University of Miami CurrentSince Aug 1, 2021 Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

900 NW 17th St
Miami, FL 33136
Phone (305) 243-6605

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

160 NW 170th St
North Miami Beach, FL 33169
Phone (305) 585-8957

1155 S Congress Ave
Ste C
West Palm Beach, FL 33406
Phone 5617661300601

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Organizations & group practices 7

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": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1740890466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18574 NW 53RD AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330555342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18574 NW 53RD AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330555342",
            "telephone_number": "786-351-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREJON",
        "first_name": "MARLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11008143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

Verify at the official NPI Registry.