THERESA GLORIA ST PHILIPPE ARNP
NPI 1306218243
Nurse Practitioner in Miami, FL

Q: What is Theresa St Philippe's NPI number?

The NPI number for Theresa St Philippe is 1306218243. It was assigned to this individual provider in the NPPES registry on October 29, 2015.

Q: What is Theresa St Philippe's specialty?

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

Active since October 29, 2015PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

1321 NW 14TH ST STE 510, MIAMI, FL 33125(305) 689-5554 Get Directions Write a Review

NPPES record last updated: January 18, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 18, 2023, Jan 9, 2020 (2 updates tracked since 2020).

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About Theresa Gloria St Philippe Arnp NPPES

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

THERESA GLORIA ST PHILIPPE ARNP (NPI 1306218243) is an individual nurse practitioner in Miami, Florida, licensed in Florida (APRN9345133) and active in the NPI registry since October 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1306218243

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameTHERESA GLORIA ST PHILIPPECredential: ARNP

Location Address1321 NW 14TH ST STE 510Miami, FL 33125-1659

Mailing Address1321 Nw 14th St Ste 510Miami, FL 33125-1659 · (305) 243-5554

Phone(305) 689-5554

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateOctober 29, 2015

Last NPPES UpdateJanuary 18, 20232 updates tracked since enumeration

NPPES CertifiedJanuary 18, 2023

✔ NPI 1306218243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in FL · APRN9345133

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.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License APRN9345133 (FL)

1321 NW 14TH ST STE 510, Miami, FL 33125

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Oscar Health Maintenance Organization of Florida, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Theresa Gloria St Philippe Arnp 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 ID5799028213

PECOS Enrollment IDI20190524000503

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

164 services119 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

107 services79 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

21 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33125 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

97.11

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture

Lower rates are better for this measure.

3%66 patients

Breast Cancer Screening

46%322 patients2/55-star benchmark: 93%

Cervical Cancer Screening

35%242 patients2/55-star benchmark: 98%

Colorectal Cancer Screening

49%690 patients3/55-star benchmark: 88%

Controlling High Blood Pressure

72%622 patients4/55-star benchmark: 91%

Diabetes: Eye Exam

47%232 patients2/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

31%232 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

100%1,592 patients5/55-star benchmark: 100%

e-Prescribing

98%390 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

99%549 patients4/55-star benchmark: 100%

HIV Screening

38%568 patients3/55-star benchmark: 60%

Oncology: Medical and Radiation - Pain Intensity Quantified

92%26 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

55%946 patients3/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

84%800 patients4/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

32%578 patients3/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 98% · 343 patients

Patients screened: 100% · 343 patients

70%23 patients3/55-star benchmark: 100%

Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation

85%40 patients

Provide Patients Electronic Access to Their Health Information

100%370 patients5/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 10% · 580 patients

Patients totalRate: 15% · 580 patients

14%580 patients3/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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Other Providers at the Same Location NPPES 9

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

JOSE R JIRON ARNP

Nurse Practitioner (Family)