Individual provider Active NPI

Jaime Lynn Bozentka, M.D.

  • Pediatric Anesthesiology Physician
  • Miami, FL
National Provider Identifier
1114211554
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
ME155333 Issued in FL
Practice address
3100 SW 62ND Ave
Miami, FL 33155-3009
Phone
(646) 939-0592
NPI assigned
Jun 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X 35.823511 OH
Pediatric Anesthesiology Physician 207LP3000X 036153164 IL
Pediatric Anesthesiology Physician 207LP3000X TP381 KY
Pediatric Anesthesiology Physician 207LP3000X ME155333 FL Primary

Addresses

Primary practice location

3100 SW 62ND Ave
Miami, FL 33155-3009

Mailing address

225 N Columbus Dr Apt 5213
Chicago, IL 60601-5209
Phone (646) 939-0592

Other practice location 1

225 E Chicago Ave
Chicago, IL 60611-2991
Phone (800) 543-7362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME155333FLMDPediatric Anesthesiology Physician
036153164ILMDPediatric Anesthesiology Physician
35.823511OHMDPediatric Anesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1114211554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N COLUMBUS DR APT 5213",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606015209",
            "telephone_number": "646-939-0592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SW 62ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553009",
            "telephone_number": "646-939-0592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 E Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112991",
            "country_code": "US",
            "telephone_number": "800-543-7362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOZENTKA",
        "first_name": "JAIME",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "OH",
            "license": "35.823511",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "IL",
            "license": "036153164",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "KY",
            "license": "TP381",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "FL",
            "license": "ME155333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.