NPIMap

Organization Active NPI

Public Health Trust of Miami Dade County Florida

Doing business as Jackson Medical Pavilion

  • Urgent Care Clinic/Center
  • Coral Gables, FL
National Provider Identifier
1902551518
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Doing business as
Jackson Medical Pavilion
Practice address
3737 SW 8TH St
Coral Gables, FL 33134-3129
Phone
(305) 585-3701
NPI assigned
Feb 14, 2022
Last updated
Mar 13, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Mark T Knight
Title
Evp/Cfo
Phone
(305) 585-4211

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary
General Acute Care Hospital 282N00000X NU

Addresses

Primary practice location

3737 SW 8TH St
Coral Gables, FL 33134-3129

Mailing address

PO Box 12493
Miami, FL 33101-2493
Phone (786) 466-8101

Other names 1

  • JACKSON MEDICAL PAVILION Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060208000214 FL Part A Provider - Hospital 8628981925 22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami, FL; North Miami Beach, FL; Miami Beach, FL; North Miami, FL; Opa Locka, FL; Village of Palmetto Bay, FL; Homestead, FL; Doral, FL…
O20171025000826 FL Part B Supplier - Hospital Department(S) 8628981925 Receives reassigned benefits from 45 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami, FL; North Miami, FL; Miami Gardens, FL; Miami Beach, FL; Doral, FL; Cutler Bay, FL; Coral Gables, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902551518. Details of each certification follow.

Hospital certification: CCN 100022

Legal name
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jul 9, 2020
Beds
2,255
Ownership / control type
Hospital district or authority
Organization structure
GovernmentNon-profit
Enrollment address
1611 NW 12TH Ave
Miami, FL 33136-1005
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

Care Compare: Hospital

Medicare Care Compare
Listed as
Jackson Health SystemCCN 100022 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Abdul Mmemon MD

Networks

  • HealthSun Health Plans Network

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Myriam Torres Individual Corporate OfficerVP Revenue Cycle Management Mar 21, 2016
Corporate DirectorVP Revenue Cycle Management Mar 21, 2016
W-2 Managing EmployeeVP Revenue Cycle Management Mar 21, 2016
Operational/Managerial ControlVP Revenue Cycle Management Mar 21, 2016
Mark T Knight Individual Corporate OfficerEvp, Chief Financial Officer Nov 1, 2010
Corporate DirectorEvp, Chief Financial Officer Nov 1, 2011
W-2 Managing EmployeeEvp, Chief Financial Officer Nov 1, 2010
Operational/Managerial ControlEvp, Chief Financial Officer Nov 1, 2011
Carlos Migoya Individual Corporate OfficerChief Executive Officer May 2, 2011
Corporate DirectorChief Executive Officer May 2, 2011
W-2 Managing EmployeeChief Executive Officer May 2, 2011
Operational/Managerial ControlChief Executive Officer May 2, 2011
Public Health Trust of Miami Dade County Florida Organization, Miami, FL Non-profit Operational/Managerial Control Oct 1, 1973 100%

Owners & managing parties with NPI records 12

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1,674

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,674

NPI Registry JSON

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1902551518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12493",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331012493",
            "telephone_number": "786-466-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 SW 8TH ST",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331343129",
            "telephone_number": "305-585-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA",
        "enumeration_date": "2022-02-14",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EVP/CFO",
        "authorized_official_telephone_number": "305-585-4211"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACKSON MEDICAL PAVILION",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JACKSON MEDICAL PAVILION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.