Individual provider Active NPI

Katiana Legagneur

  • Family Nurse Practitioner
  • Miramar, FL
National Provider Identifier
1023686920
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11012432 Issued in FL
Practice address
2341 Pine Tree Dr
Miramar, FL 33023-4549
Phone
(239) 324-6854
NPI assigned
Jun 16, 2021
Last updated
Jun 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11012432 FL Primary

Addresses

Primary practice location

2341 Pine Tree Dr
Miramar, FL 33023-4549

Mailing address

2341 Pine Tree Dr
Miramar, FL 33023-4549
Phone (239) 324-6854

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241004001244 FL Practitioner - Nurse Practitioner 1557892296
I20241216001849 NY Practitioner - Nurse Practitioner 1557892296 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11012432FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brookview Medical Associates, PLLC CurrentSince Oct 12, 2024 Accepting new patients

Locations

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1023686920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2341 PINE TREE DR",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330234549",
            "telephone_number": "239-324-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 PINE TREE DR",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330234549",
            "telephone_number": "239-324-6854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGAGNEUR",
        "first_name": "KATIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11012432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.