Individual provider Active NPI

Carlos Ernesto De Cabrera, ARNP

  • Family Nurse Practitioner
  • Middletown, NY
National Provider Identifier
1952884637
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
349572 Issued in NY
Practice address
111 Maltese Dr
Middletown, NY 10940-2141
Phone
(845) 342-4774
NPI assigned
Sep 10, 2018
Last updated
Oct 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 349572 NY Primary

Addresses

Primary practice location

111 Maltese Dr
Middletown, NY 10940-2141

Mailing address

111 Maltese Dr
Middletown, NY 10940-2141
Phone (845) 342-4774

Other identifiers 1

IdentifierTypeStateIssuer
07246555MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191119002015 FL Practitioner - Nurse Practitioner 3375975097 Reassigns benefits to 1 organization
I20220803001149 NY Practitioner - Nurse Practitioner 3375975097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middletown Medical PCGroup PAC ID 2567464308, 177 clinicians

Practice addresses (Care Compare)

111 Maltese Dr
Middletown, NY 10940-2115
Phone (845) 342-4774

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.92 of 100Reported as group
Quality
68.46
Promoting interoperability
99
Improvement activities
40
Cost
77.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
349572NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Medical PC CurrentSince Jul 5, 2022 Accepting new patients
Randolph Borrero MD PA CurrentSince May 15, 2024 Accepting new patients
Kidney and Hypertension Specialist of Miami PA CurrentSince Jul 27, 2019 Accepting new patients
Middletown Medical PC CurrentSince Jul 5, 2022 Accepting new patients

Locations

1190 NW 95th St
Ste 207
Miami, FL 33150
Phone (305) 400-8518

111 Maltese Dr
Middletown, NY 10940

419 E Main St
Middletown, NY 10940
Phone (845) 341-0213

75 Maltese Dr
Middletown, NY 10940

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: carlos.decabrera@mmpc.eclinicaldirectplus.com

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, 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": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1952884637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MALTESE DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402141",
            "telephone_number": "845-342-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MALTESE DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402141",
            "telephone_number": "845-342-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE CABRERA",
        "first_name": "CARLOS",
        "middle_name": "ERNESTO",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-10",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "349572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07246555",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.