NPIMap

Individual provider Active NPI

Marissa J Defreitas, M.D.

  • Pediatric Nephrology Physician
  • Miami, FL
National Provider Identifier
1861635674
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
ME123124 Issued in FL
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1005
Phone
(305) 585-6726
NPI assigned
Apr 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME123124 FL
Pediatric Nephrology Physician 2080P0210X ME123124 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1005

Mailing address

PO Box 16960
Division of Pediatric Nephrology, (M-714)
Miami, FL 33101-6960
Phone (954) 599-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150915001282 FL Practitioner - Pediatric Medicine 4486961091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Chicago, Pritzker School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

1601 NW 12TH Ave 1St FL
MCCD
Miami, FL 33136-1005
Phone (305) 689-7210

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
78.79
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME123124FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Pediatrics CurrentSince Jan 1, 2020 Accepting new patients
University of Miami Current Accepting new patients
University of Miami Past Accepting new patients
University of Miami Pediatrics Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

8932 SW 97th Ave
Miami, FL 33176
Phone (305) 270-3485

1660 NW 7th Ct
Miami, FL 33136
Phone (305) 355-9403

1611 NW 12th Ave
Ste 600B
Miami, FL 33136
Phone (305) 355-1303

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1601 NW 12th Ave
Fl 1
Miami, FL 33136
Phone (305) 243-3166

Organizations & group practices 4

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.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1861635674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16960",
            "address_2": "DIVISION OF PEDIATRIC NEPHROLOGY, (M-714)",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331016960",
            "telephone_number": "954-599-7200"
        },
        {
            "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": "331361005",
            "telephone_number": "305-585-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFREITAS",
        "first_name": "MARISSA",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-08",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME123124",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "FL",
            "license": "ME123124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.