Individual provider Active NPI

Cristina Isabel Matheus Fernandez, MD

  • Pediatrics Physician
  • Miami Beach, FL
National Provider Identifier
1770045262
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME155667 Issued in FL
Practice address
1221 71St St
Miami Beach, FL 33141-3647
Phone
(305) 538-8835
Fax
(305) 994-0054
NPI assigned
Apr 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME155667 FL Primary

Addresses

Primary practice location

1221 71St St
Miami Beach, FL 33141-3647

Mailing address

11645 Biscayne Blvd Ste 207
North Miami, FL 33181-3138
Phone (305) 538-8835

Other practice location 1

11645 Biscayne Blvd Ste 103
North Miami, FL 33181-3138
Phone (305) 538-8835

Other identifiers 1

IdentifierTypeStateIssuer
115345100MedicaidFL

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
I20220927003212 FL Practitioner - Pediatric Medicine 0446636575 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME155667FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Miami Beach Community Health Center Inc CurrentSince Aug 26, 2022 Accepting new patients
Miami Beach Community Health Center Inc Current Accepting new patients
Miami Beach Community Health Center, Inc. CurrentSince Aug 26, 2022 Accepting new patients
Miami Beach Community Health Center Inc Past Accepting new patients

Locations

1221 71st St
Miami Beach, FL 33141

710 Alton Rd
Miami Beach, FL 33139

11645 Biscayne Blvd
Ste 308
North Miami, FL 33181
Phone (305) 895-0010

11645 Biscayne Blvd
Ste 309
North Miami, FL 33181
Phone (867) 920-2021

11645 Biscayne Blvd
Ste 408
North Miami, FL 33181

11645 Biscayne Blvd
Ste 103
North Miami, FL 33181

11645 Biscayne Blvd
Ste 207
North Miami, FL 33181
Phone (704) 297-9229

Organizations & group practices 4

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1770045262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD STE 207",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813138",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 71ST ST",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331413647",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11645 Biscayne Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "North Miami",
            "state": "FL",
            "postal_code": "331813138",
            "country_code": "US",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEUS FERNANDEZ",
        "first_name": "CRISTINA",
        "middle_name": "ISABEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME155667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115345100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.