Individual provider Active NPI

Sandra S Daccarett

  • Primary Care Nurse Practitioner
  • Davie, FL
National Provider Identifier
1093089245
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
ARNP9207369 Issued in FL
Practice address
5400 S University Dr Ste 301
Davie, FL 33328-5310
Phone
(954) 636-2332
NPI assigned
Mar 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X ARNP9207369 FL Primary
Gerontology Nurse Practitioner 363LG0600X ARNP9207369 FL

Addresses

Primary practice location

5400 S University Dr Ste 301
Davie, FL 33328-5310

Mailing address

5400 S University Dr Ste 301
Davie, FL 33328-5310
Phone (954) 636-2332

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
I20131230001110 FL Practitioner - Nurse Practitioner 6406083161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Design Neuroscience Center PLGroup PAC ID 9032110192, 23 clinicians

Practice addresses (Care Compare)

14400 NW 77TH CT
Suite 306
Miami Lakes, FL 33016-1592
Phone (305) 653-5155

5400 S University Dr
Suite 301
Davie, FL 33328-5310
Phone (954) 636-2332

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Design Neuroscience Center PL CurrentSince Dec 1, 2023 Accepting new patients
S D Healthcare Inc CurrentSince Feb 3, 2023 Accepting new patients

Locations

5400 S University Dr
Ste 301
Davie, FL 33328
Phone (954) 361-6151

8875 NW 23rd St
Doral, FL 33172
Phone (305) 653-5155

21110 Biscayne Blvd
Ste 201
Miami, FL 33180
Phone (305) 653-5155

14400 NW 77th Ct
Ste 306
Miami Lakes, FL 33016
Phone (305) 653-5155

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1093089245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 S UNIVERSITY DR STE 301",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285310",
            "telephone_number": "954-636-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 S UNIVERSITY DR STE 301",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285310",
            "telephone_number": "954-636-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACCARETT",
        "first_name": "SANDRA",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-06",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9207369",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP9207369",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.