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GUSTAVO EMILIO PENA-LAGRAVE
NPI 1427216571
Family Medicine in Hialeah, FL

Active since May 27, 2008PECOS EnrolledAccepts Medicare Assignment
18610 NW 87TH AVE STE 101, HIALEAH, FL 33015(305) 829-5000 Get Directions Write a Review

NPPES record last updated: November 2, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 2, 2021, Nov 7, 2019 (2 updates tracked since 2019).

About Gustavo Emilio Pena-lagrave NPPES

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

GUSTAVO EMILIO PENA-LAGRAVE (NPI 1427216571) is an individual family medicine provider in Hialeah, Florida, licensed in Florida (ME141476) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS, maintains a secondary practice location in Washington, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1427216571
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameGUSTAVO EMILIO PENA-LAGRAVE
Location Address18610 NW 87TH AVE STE 101Hialeah, FL 33015-3519
Mailing Address110 Irving St NwWashington, DC 20010-3017 · (202) 877-7227
Phone(305) 829-5000
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateMay 27, 2008
Last NPPES UpdateNovember 2, 20212 updates tracked since enumeration
NPPES CertifiedOctober 22, 2021
✔ NPI 1427216571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in FL · ME141476
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
18610 NW 87TH AVE STE 101, Hialeah, FL 33015
Open in Google Maps ↗

Secondary Practice Location 1

Location 1110 Irving St NWWashington, DC 20010-3017 · Phone (202) 877-7227

Accepted Insurance

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

Gustavo Emilio Pena-lagrave 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 ID5991133399
PECOS Enrollment IDI20200318001722
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 Reassignments

3

Medicare enrollment records show Gustavo Pena-lagrave reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Synergy Wellness Centers Corp
6.2 mi
Addiction (Substance Use Disorder)
17340 NW 27TH AVE
Miami Gardens, FL 33056
  • Reassigned Medicare billing, Florida enrollment
  • 2 clinicians in this Medicare group
NPI 1164057907 (786) 255-0613
Lifelong Care Corp
6.7 mi
Family
259 E 49TH ST
Hialeah, FL 33013
  • Reassigned Medicare billing, Florida enrollment
  • 5 clinicians in this Medicare group
NPI 1851968291 (305) 918-2021
American Current Care PA
17 mi
Urgent Care
1347 S ANDREWS AVE
Fort Lauderdale, FL 33316
  • Reassigned Medicare billing, Florida enrollment
  • 97 clinicians in this Medicare group
NPI 1366634172 (954) 767-9999

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

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.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
33 services33 patients
Detection test by immunoassay with direct visual observation for influenza virus 87804
This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
22 services11 patients
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811
This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33015 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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352
DME-Orthotic Devices · category DF008N
1 supplier102 claims160,800 services$5.73 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

DR. CARMEN M DE LEON-MARTINEZ MD
Family Medicine
18610 NW 87TH AVE STE 101
HIALEAH, FL 33015
Miami-Dade County (305) 829-5000
MRS. LEYANIS DELGADO NEMER APRN
Nurse Practitioner (Family)
18610 NW 87TH AVE STE 101
MIAMI GARDENS, FL 33015
Miami-Dade County (305) 930-3811
GUIDEWELL SANITAS I, LLC
Family Medicine (Hospice and Palliative Medicine)
18610 NW 87TH AVE STE 101
HIALEAH, FL 33015
Miami-Dade County (844) 665-4827
YAYLIN MARTIN GARCIA
Health and Wellness Coach
18610 NW 87TH AVE STE 101
HIALEAH, FL 33015
Miami-Dade County (844) 665-4827

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gustavo Pena-lagrave's NPI number?

The NPI number for Gustavo Pena-lagrave is 1427216571. It was assigned to this individual provider in the NPPES registry on May 27, 2008.

Where is Gustavo Pena-lagrave located?

Gustavo Pena-lagrave practices at 18610 NW 87th Ave Ste 101, Hialeah, FL 33015. The listed phone number is (305) 829-5000.

What is Gustavo Pena-lagrave's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Gustavo Pena-lagrave enrolled in Medicare?

Yes. Gustavo Pena-lagrave is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Gustavo Pena-lagrave's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gustavo Pena-lagrave reassigns Medicare benefits to 3 organizations: Synergy Wellness Centers Corp (Miami Gardens, FL), Lifelong Care Corp (Hialeah, FL) and American Current Care PA (Fort Lauderdale, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gustavo Pena-lagrave's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gustavo Pena-lagrave accept?

Health plans from Oscar Health, Oscar Health Insurance, Oscar Health Maintenance Organization of Florida, Oscar Health Plan of North Carolina, Inc and Oscar Health Plan, Inc. and 2 other insurers list Gustavo Pena-lagrave as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gustavo Pena-lagrave was last updated on November 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.