Individual provider Active NPI

Rafael A Pelegrin, MD

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1861447708
Registry record updated Jul 8, 2007
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Jul 20, 2009.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME63852 Issued in FL
Practice address
10661 N Kendall Dr
Suite 113
Miami, FL 33176-1550
Phone
(305) 279-1929
Fax
(305) 279-1935
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 ME63852 FL Primary

Addresses

Primary practice location

10661 N Kendall Dr
Suite 113
Miami, FL 33176-1550

Mailing address

10661 N Kendall Dr
Suite 113
Miami, FL 33176-1550
Phone (305) 279-1929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME63852FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Key Largo Medical Center Corp Past Accepting new patients
The Gables Rehabilitation Center, LLC Family Medicine Past Accepting new patients
Saez Medical Center Past Accepting new patients
A & O Diagnostic Center Inc PastSince Jul 11, 2002 Accepting new patients
Rafael Pelegrin M.D,Medical GRP, LLC Past Accepting new patients
L & H Diagnostic Center Past Accepting new patients
Charity Medical Group Inc Past Accepting new patients

Organizations & group practices 7

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861447708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10661 N KENDALL DR",
            "address_2": "SUITE 113",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761550",
            "telephone_number": "305-279-1929",
            "fax_number": "305-279-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10661 N KENDALL DR",
            "address_2": "SUITE 113",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761550",
            "telephone_number": "305-279-1929",
            "fax_number": "305-279-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELEGRIN",
        "first_name": "RAFAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME63852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.