- Medicare Primary Care in Opa-locka, FL

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is a medicare enrolled primary clinic (Clinic/center - Mental Health (including Community Mental Health Center)) in Opa-locka, Florida. The current practice location for is 15055 Nw 27 Avenue, Opa-locka, Florida. For appointments, you can reach them via phone at (305) 466-2800. The mailing address for is P.o. Box 12493, Miami, Florida and phone number is () -.

is licensed to practice in Florida (license number 8511). The clinic also participates in the medicare program and its NPI number is 1063417483. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (305) 466-2800.

Contact Information

15055 Nw 27 Avenue
Opa-locka
FL 33054-3365
(305) 466-2800
(786) 466-2748

Map and Direction


Primary Care Clinic Profile

Full Name
SpecialityClinic/Center
Location15055 Nw 27 Avenue, Opa-locka, Florida
Authorized Official Name and PositionMark T Knight (CHIEF FINANCIAL OFFICER)
Authorized Official Contact3055857979
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

P.o. Box 12493
Miami
FL 33101-2493

Ph: () -
15055 Nw 27 Avenue
Opa-locka
FL 33054-3365

Ph: (305) 466-2800

NPI Details:

NPI Number1063417483
Provider Enumeration Date06/14/2005
Last Update Date09/04/2020

Medicare PECOS Information:

Medicare PECOS PAC ID8628981925
Medicare Enrollment IDO20031217000574

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063417483NPI-NPPES
014357500MedicaidFL
075501000MedicaidFL
142202200OtherFLASSISTED CARE SERVICES
005851600MedicaidFL
912237100MedicaidFL
912301600MedicaidFL
686226896MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QC1500XClinic/center - Community Health 8511 (Florida)Secondary
261QM0801XClinic/center - Mental Health (including Community Mental Health Center) 8511 (Florida)Primary
261QM0850XClinic/center - Adult Mental Health 8511 (Florida)Secondary
261QM0855XClinic/center - Adolescent And Children Mental Health 8511 (Florida)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameCarlos R Danger
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1508890153
PECOS PAC ID: 3870547888
Enrollment ID: I20050314000847
Provider NameAlexander G Perez
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1790908564
PECOS PAC ID: 7416003611
Enrollment ID: I20090912000121
Provider NameRichard M Dreize
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1114135001
PECOS PAC ID: 1759437320
Enrollment ID: I20090923000319
Provider NameGabriel L Martinez
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1962603340
PECOS PAC ID: 3870649312
Enrollment ID: I20090924000183
Provider NameJudd Scott Christian
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1871703942
PECOS PAC ID: 9638218753
Enrollment ID: I20091203000310
Provider NameJonathan L Cohen
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1437370517
PECOS PAC ID: 9335274950
Enrollment ID: I20100320000070
Provider NameSusan J Ireland
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1154547164
PECOS PAC ID: 0345371811
Enrollment ID: I20100628000072
Provider NameGisela Aguila-puentes
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1134345903
PECOS PAC ID: 7214069269
Enrollment ID: I20100709000724
Provider NameMario Olavarria
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1427275148
PECOS PAC ID: 9739211780
Enrollment ID: I20100709000758
Provider NameLisa Christina Gonzalez-alpizar
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1831415223
PECOS PAC ID: 4587798848
Enrollment ID: I20100823000499
Provider NameMercy M Gonzalez
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1487775714
PECOS PAC ID: 3779767595
Enrollment ID: I20110401000756
Provider NameJessica Herron
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568741320
PECOS PAC ID: 0345413407
Enrollment ID: I20120516000686
Provider NameHorace A Ellis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457328734
PECOS PAC ID: 3375792617
Enrollment ID: I20121002000703
Provider NameErnesto Grenier
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1366614927
PECOS PAC ID: 0446401129
Enrollment ID: I20121130000207
Provider NameNelson Emmanuel Cordero-torres
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1033351184
PECOS PAC ID: 9537308101
Enrollment ID: I20130612000497
Provider NameBarbara Sparacino
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1730340720
PECOS PAC ID: 6305083403
Enrollment ID: I20130729000183
Provider NameMelisa Oliva
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1477866465
PECOS PAC ID: 4880828540
Enrollment ID: I20131011000637
Provider NameChristopher B Benton
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1356338784
PECOS PAC ID: 4880615657
Enrollment ID: I20150427000343
Provider NameSheba Kumbhani
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1043548779
PECOS PAC ID: 9335332469
Enrollment ID: I20150728005063
Provider NameCarolina Avila
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1295083376
PECOS PAC ID: 4981912490
Enrollment ID: I20151002001623
Provider NameHortensa Valeron
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1932427044
PECOS PAC ID: 5698075182
Enrollment ID: I20151207000916
Provider NameSiramene Abraham
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1467890392
PECOS PAC ID: 4688970817
Enrollment ID: I20160314001676
Provider NameFrank A Baez
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1821335209
PECOS PAC ID: 4880972470
Enrollment ID: I20161102001972
Provider NameEquilla Vonzetti Cherry
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689029480
PECOS PAC ID: 9739474123
Enrollment ID: I20170825003094
Provider NameBarbara Coffey
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1578536348
PECOS PAC ID: 1052687787
Enrollment ID: I20171025001984
Provider NameTamala J Russell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639414337
PECOS PAC ID: 9234496571
Enrollment ID: I20171122000602
Provider NameIlona Moroz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306358924
PECOS PAC ID: 8426310335
Enrollment ID: I20180312002412
Provider NameTania Maria Torres
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912416926
PECOS PAC ID: 7911260591
Enrollment ID: I20180412001159
Provider NameNiveditha Bhaskarla
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1871988741
PECOS PAC ID: 8426312026
Enrollment ID: I20180508000605
Provider NameHeather R Warren
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992202659
PECOS PAC ID: 7719237148
Enrollment ID: I20180906000973
Provider NameAndres Jesus Vazquez Rodriguez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467600866
PECOS PAC ID: 2668718586
Enrollment ID: I20190115001226
Provider NamePerette Turenne
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568912889
PECOS PAC ID: 1557607397
Enrollment ID: I20190115002185
Provider NameKeith R Lit
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1316375710
PECOS PAC ID: 2466799101
Enrollment ID: I20190204000397
Provider NameMadeleine Reyes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992292106
PECOS PAC ID: 0345587093
Enrollment ID: I20190204001020
Provider NameMaria T Rivas Torres
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1942465505
PECOS PAC ID: 6305033309
Enrollment ID: I20190226001048
Provider NameClara Lora Ospina
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1871765941
PECOS PAC ID: 5799951778
Enrollment ID: I20190410002614
Provider NameDurim Bozhdaraj
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1750791281
PECOS PAC ID: 5294078143
Enrollment ID: I20190517000200
Provider NameAleksandr Kaipov
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1558767392
PECOS PAC ID: 9537402805
Enrollment ID: I20190530001386
Provider NameOctavio Miguel Alfonso
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881100121
PECOS PAC ID: 7517299399
Enrollment ID: I20191028002567
Provider NameAarti Jerath
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1871872994
PECOS PAC ID: 9436581303
Enrollment ID: I20191114000808
Provider NameCrystal N Allen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316598717
PECOS PAC ID: 9133552854
Enrollment ID: I20191210001646
Provider NameDanielle Hammons
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598319246
PECOS PAC ID: 9436588951
Enrollment ID: I20200612001426
Provider NameCatherine De La Osa
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1043712425
PECOS PAC ID: 2466874193
Enrollment ID: I20200625000384
Provider NameNadege Francois
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114563418
PECOS PAC ID: 6204248537
Enrollment ID: I20201210001355
Provider NameSuchitra Joshi
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1053756387
PECOS PAC ID: 0345549317
Enrollment ID: I20210108000652
Provider NameNatasha L Poulopoulos
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1336754480
PECOS PAC ID: 3779998596
Enrollment ID: I20210209000359
Provider NameJonathan M Parker
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1124480223
PECOS PAC ID: 4284049123
Enrollment ID: I20210226000980
Provider NameErnesto Lajara
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083183859
PECOS PAC ID: 8628486180
Enrollment ID: I20210421002279
Provider NameDaniel Maass
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1003264953
PECOS PAC ID: 8527467083
Enrollment ID: I20210603001119
Provider NameTenishia Santiago
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497254932
PECOS PAC ID: 7113277369
Enrollment ID: I20211210002310
Provider NameJonathan C Dugdill
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1790850246
PECOS PAC ID: 5294733119
Enrollment ID: I20211220001096
Provider NameDhruti Patel
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1619325545
PECOS PAC ID: 5395137426
Enrollment ID: I20220121000631
Provider NameMatthew T Bojanowski
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1497286512
PECOS PAC ID: 7113319054
Enrollment ID: I20220126001803
Provider NameMatthew Thompson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336896687
PECOS PAC ID: 2264829464
Enrollment ID: I20220418000818
Provider NameJulie Guzzardi
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1538522255
PECOS PAC ID: 5193102218
Enrollment ID: I20220511001235
Provider NameAlec Orlick
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962844803
PECOS PAC ID: 6709109283
Enrollment ID: I20230323000015
Provider NameAlexander Albert Katz
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1790245223
PECOS PAC ID: 1355700857
Enrollment ID: I20230630001539
Provider NameFeras Abdulaziz Alkharboush
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1194212555
PECOS PAC ID: 3072974302
Enrollment ID: I20230802001497
Provider NameDariel R Guerra
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487390878
PECOS PAC ID: 2062873342
Enrollment ID: I20230802003969
Provider NameAsh Mehra
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1548823461
PECOS PAC ID: 8123355336
Enrollment ID: I20231023001832
Provider NameAna Maria Ojeda
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1871825844
PECOS PAC ID: 8123474236
Enrollment ID: I20231026000172
Provider NameSamantha Leigh Zaid
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1629348339
PECOS PAC ID: 7810348653
Enrollment ID: I20240105003161
Provider NameAhmed Valdes
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1558821488
PECOS PAC ID: 8820431794
Enrollment ID: I20240207002531
Provider NameSofia Isabel Ricardo
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1659148153
PECOS PAC ID: 1355788951
Enrollment ID: I20240319000636
Provider NameJussethy D Cortina
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1598190159
PECOS PAC ID: 1557709508
Enrollment ID: I20240409004927
Provider NameKeneil Kirk Patrick Brown
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1245790971
PECOS PAC ID: 3173067444
Enrollment ID: I20240627000991

Reviews and Comments


Clinic/Center in Opa-locka, FL


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.