Individual provider Active NPI

Loida Mercedes Severino, MD

  • Pediatrics Physician
  • Miami, FL
National Provider Identifier
1881759058
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ACN183 Issued in FL
Practice address
3601 Federal Hwy
Miami, FL 33137-3795
Phone
(305) 576-6611
Fax
(786) 476-2816
NPI assigned
Dec 27, 2006
Last updated
Sep 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ACN183 FL
Pediatrics Physician 208000000X ACN183 FL Primary

Addresses

Primary practice location

3601 Federal Hwy
Miami, FL 33137-3795

Mailing address

3601 Federal Hwy
Miami, FL 33137-3795
Phone (305) 576-6611

Other identifiers 1

IdentifierTypeStateIssuer
265235800MedicaidFL

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
I20080626000683 FL Practitioner - Pediatric Medicine 6507938172 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Borinquen Health Care Center, Inc. CurrentSince Jul 11, 2010 Accepting new patients
Borinquen Health Care Center, Inc. CurrentSince Jul 11, 2010 Accepting new patients

Locations

3601 Federal Hwy
Miami, FL 33137
Phone (305) 567-6611

5040 NW 7th St
Ste 100
Miami, FL 33126
Phone 7878400052 ext. 262

Interoperability endpoints

  • Direct secure messaging: loida.severino.1@8506.direct.athenahealth.com

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, 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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1881759058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 FEDERAL HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331373795",
            "telephone_number": "305-576-6611",
            "fax_number": "786-476-2819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 FEDERAL HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331373795",
            "telephone_number": "305-576-6611",
            "fax_number": "786-476-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERINO",
        "first_name": "LOIDA",
        "middle_name": "MERCEDES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ACN183",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ACN183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265235800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.