Individual provider Active NPI

Kayra Altagracia Cepin Plasencio, M.D.

  • Family Medicine Physician
  • Hollywood, FL
National Provider Identifier
1780841809
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME112208 Issued in FL
Practice address
7261 Sheridan St Ste 100D
Hollywood, FL 33024-2708
Phone
(954) 534-7696
Fax
(954) 534-7731
NPI assigned
May 16, 2008
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME112208 FL Primary

Addresses

Primary practice location

7261 Sheridan St Ste 100D
Hollywood, FL 33024-2708

Mailing address

7261 Sheridan St Ste 100D
Hollywood, FL 33024-2708
Phone (954) 534-7696

Other identifiers 2

IdentifierTypeStateIssuer
022764400MedicaidFL
ME112208OtherFLMEDICAL LICENSE

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
I20130325000124 FL Practitioner - Family Practice 4082759576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabclinics Pta IncGroup PAC ID 0547237497, shared by 11 NPIs, 209 clinicians
Sole Health LLCGroup PAC ID 7214296219, 3 clinicians

Practice addresses (Care Compare)

13645 Biscayne Blvd
North Miami Beach, FL 33181-1617
Phone (305) 949-2700

7261 Sheridan St
Suite 100D
Hollywood, FL 33024-2708
Phone (954) 534-7696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME112208FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vicioso Medical and Addiction Services LLC PastSince Jan 15, 2018 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDACBD/Endpoint/IDACBD

Organizations & group practices 2

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": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1780841809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 SHERIDAN ST STE 100D",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242708",
            "telephone_number": "954-534-7696",
            "fax_number": "954-534-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7261 SHERIDAN ST STE 100D",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242708",
            "telephone_number": "954-534-7696",
            "fax_number": "954-534-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEPIN PLASENCIO",
        "first_name": "KAYRA",
        "middle_name": "ALTAGRACIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME112208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022764400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME112208",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.