Individual provider Active NPI

William Van Jensen, DO

  • Family Medicine Physician
  • Pompano Beach, FL
National Provider Identifier
1144339912
Registry record updated Dec 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS 5965 Issued in FL
Practice address
1800 N Federal Hwy
Suite 104
Pompano Beach, FL 33062-1034
Phone
(954) 782-0010
Fax
(954) 781-2139
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2009

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 OS 5965 FL Primary

Addresses

Primary practice location

1800 N Federal Hwy
Suite 104
Pompano Beach, FL 33062-1034

Mailing address

1800 N Federal Hwy
Suite 104
Pompano Beach, FL 33062-1034
Phone (954) 782-0010

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101122000367 FL Practitioner - Family Practice 8820145519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hernando Pasco Primary Care LLCGroup PAC ID 0547231474, 88 clinicians

Practice addresses (Care Compare)

11373 Cortez Blvd
Brooksville, FL 34613-5405
Phone (352) 596-3032

1800 N Federal Hwy
Suite 104
Pompano Beach, FL 33062-1011
Phone (954) 782-0010

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS 5965FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hernando Pasco Primary Care LLC Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
Independant Ipa,LLC Past Accepting new patients

Locations

11373 Cortez Blvd
Ste 206
Brooksville, FL 34613
Phone (352) 596-3032

1800 N Federal Hwy
Ste 104
Pompano Beach, FL 33062
Phone (954) 782-0010

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HIBHCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CIDHCD

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.

Hospital & facility affiliations 5

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1144339912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N FEDERAL HWY",
            "address_2": "SUITE 104",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330621034",
            "telephone_number": "954-782-0010",
            "fax_number": "954-781-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N FEDERAL HWY",
            "address_2": "SUITE 104",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330621034",
            "telephone_number": "954-782-0010",
            "fax_number": "954-781-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "WILLIAM",
        "middle_name": "VAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS 5965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.