Individual provider Active NPI

Johandra M Consuegra, APRN

  • Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1881417012
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11036290 Issued in FL
Practice address
732 E 31St St
Hialeah, FL 33013-3339
Phone
(786) 804-7736
NPI assigned
Nov 5, 2024
Last updated
Nov 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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 APRN11036290 FL Primary

Addresses

Primary practice location

732 E 31St St
Hialeah, FL 33013-3339

Mailing address

732 E 31St St
Hialeah, FL 33013-3339
Phone (786) 804-7736

Other names 1

  • Ms. Johandra M Consuegra Professional name

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
I20241218001242 FL Practitioner - Nurse Practitioner 8022448158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16191 NW 57TH Ave
Miami Lakes, FL 33014-6707
Phone (786) 715-6243

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11036290FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
All in One Care Solutions LLC CurrentSince Nov 20, 2024 Accepting new patients
Golden Gate Medical Group Corp Current Accepting new patients
Golden Gate Mental Health Corp Current Accepting new patients
Eden Mental Health Center Corp. CurrentSince Mar 30, 2020 Accepting new patients

Locations

16191 NW 57th Ave
Miami Lakes, FL 33014
Phone (786) 715-6243

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1881417012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 E 31ST ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133339",
            "telephone_number": "786-804-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 E 31ST ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133339",
            "telephone_number": "786-804-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSUEGRA",
        "first_name": "JOHANDRA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11036290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHANDRA",
            "last_name": "CONSUEGRA",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.