Individual provider Active NPI

Thitiporn Lertratanakul Shaffer, ARNP

  • Acute Care Nurse Practitioner
  • Miami, FL
National Provider Identifier
1942516885
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN2118932 Issued in FL
Practice address
8900 N Kendall Dr
Miami, FL 33176-2197
Phone
(305) 928-7249
Fax
(305) 630-3632
NPI assigned
Aug 30, 2010
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN2118932 FL Primary
Adult Health Nurse Practitioner 363LA2200X APRN2118932 FL
Licensed Practical Nurse 164W00000X ARNP2118932 FL

Addresses

Primary practice location

8900 N Kendall Dr
Miami, FL 33176-2197

Mailing address

8370 W Flagler St Ste 226
Miami, FL 33144-2040
Phone (305) 928-7249

Other identifiers 2

IdentifierTypeStateIssuer
ARNP2118932OtherFLLICENSE NO.
112888600MedicaidFL

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
I20110404000259 FL Practitioner - Nurse Practitioner 0648454405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Florida Critical Care Services LLCGroup PAC ID 2466714241, 151 clinicians

Practice addresses (Care Compare)

8900 N Kendall Dr
Miami, FL 33176-2118
Phone (305) 661-9404

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP2118932FLMDLicensed Practical Nurse
APRN2118932FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Critical Care Services LLC CurrentSince Oct 26, 2019 Accepting new patients

Locations

8370 W Flagler St
Ste 226
Miami, FL 33144
Phone (305) 917-5414

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

Organizations & group practices 1

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": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1942516885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8370 W FLAGLER ST STE 226",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442040",
            "telephone_number": "305-928-7249",
            "fax_number": "305-630-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 N KENDALL DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762197",
            "telephone_number": "305-928-7249",
            "fax_number": "305-630-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "THITIPORN",
        "middle_name": "LERTRATANAKUL",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-30",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN2118932",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN2118932",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "ARNP2118932",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NO.",
            "identifier": "ARNP2118932",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112888600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.