MR. IVAN MAXIMIALLIANO MEDRANO JR. FNP-BC
NPI 1205562444
Nurse Practitioner in Miami, FL

Q: What is Ivan Medrano's NPI number?

The NPI number for Ivan Medrano is 1205562444. It was assigned to this individual provider in the NPPES registry on July 29, 2022.

Q: What is Ivan Medrano's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Ivan Medrano was last updated on October 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 29, 2022PECOS EnrolledAccepts Medicare Assignment

1400 NW 12TH AVE STE 2, MIAMI, FL 33136(305) 689-7600(305) 243-1353 Get Directions Write a Review

NPPES record last updated: October 18, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 18, 2023, May 25, 2023, Jul 29, 2022 (3 updates tracked since 2022).

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About Mr. Ivan Maximialliano Medrano Jr. Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. IVAN MAXIMIALLIANO MEDRANO JR. FNP-BC (NPI 1205562444) is an individual nurse practitioner in Miami, Florida, licensed in Florida (APRN11021122) and active in the NPI registry since July 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1205562444

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameMR. IVAN MAXIMIALLIANO MEDRANO JR.Credential: FNP-BC

Location Address1400 NW 12TH AVE STE 2Miami, FL 33136-1003

Mailing Address1400 Nw 12th Ave Ste 2Miami, FL 33136-1003 · (305) 689-7600 · Fax (305) 243-1353

Phone(305) 689-7600

Fax(305) 243-1353

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateJuly 29, 2022

Last NPPES UpdateOctober 18, 20233 updates tracked since enumeration

NPPES CertifiedOctober 18, 2023

✔ NPI 1205562444 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in FL · APRN11021122

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

1400 NW 12TH AVE STE 2, Miami, FL 33136

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Ivan Maximialliano Medrano Jr. Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698131472

PECOS Enrollment IDI20230522000466

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ivan Medrano reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Miami

Same address

Clinical Cardiac Electrophysiology

1295 NW 14TH ST, SUITE A
Miami, FL 33125

Reassigned Medicare billing, Florida enrollment
3,639 clinicians in this Medicare group

NPI 1104232578 (305) 243-5554

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33136 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.13 typical visit price

range $60.92 – $187.05

Typical copayment $24.03 (range $15.23 – $46.76)

Most-billed visit code 99203

Established Patient

$107.17 typical visit price

range $18.99 – $150.24

Typical copayment $26.79 (range $4.74 – $37.56)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELANIE CABRERA

Nurse Practitioner (Family)