Individual provider Active NPI

Ignacio Ramon Medina, ARNP

  • Nurse Practitioner
  • South Miami, FL
National Provider Identifier
1801371638
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9374659 Issued in FL
Practice address
6129 SW 70TH St
South Miami, FL 33143-3451
Phone
(786) 516-5668
NPI assigned
Sep 27, 2018
Last updated
Sep 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9374659 FL Primary

Addresses

Primary practice location

6129 SW 70TH St
South Miami, FL 33143-3451

Mailing address

6129 SW 70TH St
South Miami, FL 33143-3451

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190109002977 FL Practitioner - Nurse Practitioner 8628314879 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9374659FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ivan Espaillat MD PA CurrentSince Nov 1, 2018 Accepting new patients

Locations

12002 SW 128th Ct
Ste 204
Miami, FL 33186
Phone (305) 234-8264

2525 SW 75th Ave
Miami, FL 33155
Phone (305) 260-1852

Organizations & group practices 1

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": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1801371638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6129 SW 70TH ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331433451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6129 SW 70TH ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331433451",
            "telephone_number": "786-516-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "IGNACIO",
        "middle_name": "RAMON",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-27",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9374659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.