Organization Active NPI

Mukamas LLC

  • Family Medicine Physician
  • Miami Beach, FL
National Provider Identifier
1770210346
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MUKAMAS LLC
Practice address
410 W 41St St # 103
Miami Beach, FL 33140-3504
Phone
(305) 720-2288
Fax
(217) 771-1814
NPI assigned
Aug 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Authorized official

Name
Rachael Nambusi, MDNPI 1003255985
Title
Ceo
Phone
(305) 744-4922

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

410 W 41St St # 103
Miami Beach, FL 33140-3504

Mailing address

410 W 41St St # 103
Miami Beach, FL 33140-3504
Phone (305) 720-2288

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220818000225 FL Part B Supplier - Clinic/Group Practice 9537542949 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL; Miami Beach, FL

National Provider Directory

National Provider Directory

Locations

410 W 41st St
#103
Miami Beach, FL 33140
Phone (305) 720-2288

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1770210346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W 41ST ST # 103",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403504",
            "telephone_number": "305-720-2288",
            "fax_number": "217-771-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W 41ST ST # 103",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403504",
            "telephone_number": "305-720-2288",
            "fax_number": "217-771-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUKAMAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-04",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "NAMBUSI",
        "authorized_official_first_name": "RACHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-744-4922",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.