Individual provider Active NPI

Alba Marina O' Bourke, MD.

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1891716908
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME90672 Issued in FL
Practice address
4155 SW 130TH Ave
#102
Miami, FL 33175-3414
Phone
(305) 223-3580
Fax
(305) 223-3582
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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 ME90672 FL Primary

Addresses

Primary practice location

4155 SW 130TH Ave
#102
Miami, FL 33175-3414

Mailing address

1611 Coral Gate Dr
Miami, FL 33145-1837
Phone (305) 441-9362

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
I20040917000602 FL Practitioner - General PracticePractitioner - Family Practice 7214905298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Complete Care Management Services Aco LLCGroup PAC ID 7012349285, 3 clinicians

Practice addresses (Care Compare)

Miramar, FL 33027
Phone (877) 212-2267

Hospital & facility affiliations

  • Caritas Home Health Care Inc Home health agency, Miami, FL, CCN 109112

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Viviana Perez MD PA General Practice CurrentSince May 10, 2017 Accepting new patients
Complete Care Management Services Aco LLC CurrentSince Aug 1, 2024 Accepting new patients
Continental Health Network, Inc. Past Accepting new patients
Med - Care Clinic Inc Past Accepting new patients
Nostrum Medical Center West Dade LLC General Practice Past Accepting new patients
Medcare Clinic LLC Past Accepting new patients
Medison Complete Health Care Co Past Accepting new patients
Adcare Medical Center Past Accepting new patients
New Life Medical Center Inc General Practice Past Accepting new patients
Jose a Esnard MD PA Past Accepting new patients

Locations

4410 W 16th Ave
Ste 26
Hialeah, FL 33012
Phone (305) 822-8883

625 Commerce Dr
Ste 105
Lakeland, FL 33813
Phone (877) 212-2267

3400 Lakeside Dr
Ste 525
Miramar, FL 33027
Phone (877) 212-2267

Interoperability endpoints

  • Direct secure messaging: albamarina.obourke@ccms.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FGBIBD

Organizations & group practices 10

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 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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1891716908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 CORAL GATE DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331451837",
            "telephone_number": "305-441-9362",
            "fax_number": "305-441-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 SW 130TH AVE",
            "address_2": "#102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753414",
            "telephone_number": "305-223-3580",
            "fax_number": "305-223-3582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O' BOURKE",
        "first_name": "ALBA MARINA",
        "credential": "MD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME90672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.