Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jomary Santiago Illas, AGACNP-BC

Individual provider Adult Health Nurse Practitioner · NPI 1720850167

Jomary Santiago Illas, AGACNP-BC is a Nurse Practitioner in Hialeah, Florida. Qualified in 2022, 4 years ago. Practices with Oak Grove Physician Services PA, a 70-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
4
Licensed in
FL
In the registry since
2023
Specialties on file
5
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Practice location Address checks out

395 W 42nd St
Hialeah, FL 33012-3914
Phone: (786) 340-7538
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 11026344 (FL)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence 11026344 (FL)
Community Health Nurse Practitioner Taxonomy 363LC1500X · Licence 11026344 (FL)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 11026344 (FL)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence 11026344 (FL)

Record details

NPI number1720850167
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorYes
NPI enumeratedOctober 30, 2023
Last updated in NPPESOctober 30, 2023
Certification dateOctober 28, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Oak Grove Physician Services Pa — 70 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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