Individual provider Active NPI

Dawn M Sepulveda, ARNP

  • Family Medicine Physician
  • Boynton Beach, FL
National Provider Identifier
1013430701
Registry record updated Jul 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
651061541 Issued in FL
Practice address
10151 Enterprise Ctr Ste 106
Boynton Beach, FL 33437-3760
Phone
(561) 734-7400
NPI assigned
Jul 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 651061541 FL Primary

Addresses

Primary practice location

10151 Enterprise Ctr Ste 106
Boynton Beach, FL 33437-3760

Mailing address

10151 Enterprise Ctr
Boynton Beach, FL 33437-3759
Phone (561) 734-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190326001843 FL Practitioner - Nurse Practitioner 9830437201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ima of South Florida LLCGroup PAC ID 6406820414, 30 clinicians

Practice addresses (Care Compare)

10151 Enterprise Ctr Boulevard
Suite 106
Boynton Beach, FL 33437-3760
Phone (561) 734-7400

Hospital & facility affiliations

  • Activa Home Health Home health agency, Boynton Beach, FL, CCN 109143
  • Bethesda Hospital East Hospital, Boynton Beach, FL, CCN 100002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ima of South Florida LLC CurrentSince Dec 23, 2018 Accepting new patients

Locations

1601 Clint Moore Rd
Ste 115
Boca Raton, FL 33487
Phone (561) 939-0760

10151 Entrprs Cntr Blvd
Ste 106
Boynton Beach, FL 33437
Phone (561) 734-7400

Interoperability endpoints

  • Direct secure messaging: dawn.sepulveda.1@31574.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1013430701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10151 ENTERPRISE CTR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373759",
            "telephone_number": "561-734-7400",
            "fax_number": "561-734-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 ENTERPRISE CTR STE 106",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373760",
            "telephone_number": "561-734-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEPULVEDA",
        "first_name": "DAWN",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "651061541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.