NPIMap

Individual provider Active NPI

Suzie Jerome-Leacock, ARNP

  • Acute Care Nurse Practitioner
  • Miami, FL
National Provider Identifier
1902348105
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
9324336 Issued in FL
Practice address
17611 NW 11TH Ave
Miami, FL 33169-4609
Phone
(305) 720-0577
NPI assigned
Nov 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN9324336 FL
Acute Care Nurse Practitioner 363LA2100X 9324336 FL Primary

Addresses

Primary practice location

17611 NW 11TH Ave
Miami, FL 33169-4609

Mailing address

17611 NW 11TH Ave
Miami, FL 33169-4609
Phone (305) 720-0577

Other identifiers 1

IdentifierTypeStateIssuer
2016009392OtherFLANCC

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
I20170327000381 FL Practitioner - Nurse Practitioner 6901181338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.01 of 100Reported as group
Quality
72.99
Promoting interoperability
82
Improvement activities
40
Cost
78.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9324336FLMDAcute Care Nurse Practitioner
APRN9324336FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 18, 2020 Accepting new patients
Eastside Hospitalists Inc CurrentSince Feb 1, 2017 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 18, 2020 Accepting new patients
Public Health Trust of Dade County Florida Past Accepting new patients

Locations

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

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

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1478390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1902348105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17611 NW 11TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331694609",
            "telephone_number": "305-720-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17611 NW 11TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331694609",
            "telephone_number": "305-720-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEROME-LEACOCK",
        "first_name": "SUZIE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-06",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9324336",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "9324336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "2016009392",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.