Individual provider Active NPI

Jessenia Menendez, PA-C

  • Medical Physician Assistant
  • Deerfield Beach, FL
National Provider Identifier
1144062316
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
260 SW Natura Ave Unit 101
Deerfield Beach, FL 33441-3026
Phone
(954) 799-9600
NPI assigned
Jun 10, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 9119133 FL
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X Primary

Addresses

Primary practice location

260 SW Natura Ave Unit 101
Deerfield Beach, FL 33441-3026

Mailing address

2899 Collins Ave Apt 504
Miami Beach, FL 33140-4410
Phone (954) 646-7714

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
I20241114003002 FL Practitioner - Physician Assistant 5698209583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Miami Medical College, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

260 SW Natura Ave
101 Green Dermatology and Cosmetic Center LLC
Deerfield Beach, FL 33441-3026
Phone (954) 481-0650

3225 Aviation Ave
Suite 700
Miami, FL 33133-4741
Phone (305) 273-4641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9119133FLMDDermatology Physician

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.

NPI Registry JSON

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1144062316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2899 COLLINS AVE APT 504",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331404410",
            "telephone_number": "954-646-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 SW NATURA AVE UNIT 101",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334413026",
            "telephone_number": "954-799-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENENDEZ",
        "first_name": "JESSENIA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "9119133",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.