Individual provider Active NPI

Jean Passe, APRN

  • Family Nurse Practitioner
  • Riviera Beach, FL
National Provider Identifier
1174176523
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11003047 Issued in FL
Practice address
2141 Oakmont Dr
Riviera Beach, FL 33404-1832
Phone
(561) 578-0868
Fax
(561) 421-8161
NPI assigned
Jul 24, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 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 11003047 FL Primary

Addresses

Primary practice location

2141 Oakmont Dr
Riviera Beach, FL 33404-1832

Mailing address

2141 Oakmont Dr
Riviera Beach, FL 33404-1832

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
I20210913000827 FL Practitioner - Nurse Practitioner 0840696126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hillsboro Allergy and Family Medicine IncGroup PAC ID 2769414432, 7 clinicians

Practice addresses (Care Compare)

220 SW Natura Ave
Deerfield Beach, FL 33441-3026
Phone (954) 360-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11003047FLMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: jean.passe@451.emedpractice.direct-ci.com

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": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1174176523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 OAKMONT DR",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334041832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 OAKMONT DR",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334041832",
            "telephone_number": "561-578-0868",
            "fax_number": "561-421-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSE",
        "first_name": "JEAN",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-24",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11003047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riviera Beach, FL

Sources for this page

Verify at the official NPI Registry.