Individual provider Active NPI

Katherine Elysse Negreira

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1831726587
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME156751 Issued in FL
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1096
Phone
(305) 585-1111
NPI assigned
Mar 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME156751 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1096

Mailing address

1611 NW 12TH Ave
Central 600-D
Miami, FL 33136
Phone (305) 585-5215

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
I20240828004495 FL Practitioner - General PracticePractitioner - General Surgery 8123567658 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME156751FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skilled Biologics, Inc. CurrentSince Aug 4, 2024 Accepting new patients
Skilled Facility Health Care Solutions Inc CurrentSince Aug 1, 2024 Accepting new patients

Locations

3746 Foothill Blvd
La Crescenta, CA 91214
Phone (323) 574-0387

5860 W Junior College Rd
Key West, FL 33040
Phone (305) 293-1299

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1831726587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "CENTRAL 600-D",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33136",
            "telephone_number": "305-585-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361096",
            "telephone_number": "305-585-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGREIRA",
        "first_name": "KATHERINE",
        "middle_name": "ELYSSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME156751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.