Individual provider Active NPI

Yesenia Marie Ibanez, MSN

  • Acute Care Nurse Practitioner
  • Miami, FL
National Provider Identifier
1972265155
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN11015808 Issued in FL
Practice address
17820 SW 149TH Ave
Miami, FL 33187-6251
Phone
(305) 721-7603
NPI assigned
Oct 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN9463825 FL
Acute Care Nurse Practitioner 363LA2100X APRN11015808 FL Primary

Addresses

Primary practice location

17820 SW 149TH Ave
Miami, FL 33187-6251

Mailing address

17820 SW 149TH Ave
Miami, FL 33187-6251
Phone (305) 721-7603

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
I20251022000636 FL Practitioner - Nurse Practitioner 3577051564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17820 SW 149TH Ave
Miami, FL 33187-6251

6100 Waterford District Dr
Suite 450
Miami, FL 33126-4692

9299 Coral Reef Dr
Suite 203
Palmetto Bay, FL 33157-1769

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11015808FLMDAcute Care Nurse Practitioner
APRN9463825FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prager Simon & Associates LLP CurrentSince Sep 1, 2025 Accepting new patients
Professional Healthcare Associates LLC Past Accepting new patients

Locations

9299 SW 152nd St
Ste 203
Palmetto Bay, FL 33157
Phone (305) 234-9180

75 Remittance Dr
Dept 6997
Chicago, IL 60675

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1972265155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17820 SW 149TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331876251",
            "telephone_number": "305-721-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17820 SW 149TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331876251",
            "telephone_number": "305-721-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBANEZ",
        "first_name": "YESENIA",
        "middle_name": "MARIE",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN9463825",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11015808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.