Individual provider Active NPI

Jean-Joseph Ganeau Rendel Jr., DNP, FNP-BC,PMHNP-BC

  • Family Nurse Practitioner
  • Bradenton, FL
National Provider Identifier
1184359390
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11020837 Issued in FL
Practice address
5266 Office Park Blvd Ste 205
Bradenton, FL 34203-3442
Phone
(941) 202-3888
Fax
(941) 236-5640
NPI assigned
Jul 21, 2022
Last updated
Jul 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11020837 FL Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11020837 FL

Addresses

Primary practice location

5266 Office Park Blvd Ste 205
Bradenton, FL 34203-3442

Mailing address

5266 Office Park Blvd Ste 205
Bradenton, FL 34203-3442
Phone (941) 202-3888

Other practice location 1

9910 Sandalfoot Blvd
Boca Raton, FL 33428-6692
Phone (561) 883-3030

Other identifiers 1

IdentifierTypeStateIssuer
1184359390MedicaidFL

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
I20231121000034 FL Practitioner - Nurse Practitioner 0840648457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Associated Family Physicians of Boca Raton, P.L.Group PAC ID 8527958941, 7 clinicians

Practice addresses (Care Compare)

17470 Brookside Trace CT
Tampa, FL 33647-6201
Phone (813) 443-5042

9910 Sandalfoot Blvd
Suite 1
Boca Raton, FL 33428-6692
Phone (561) 883-3030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11020837FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Family Physicians of Boca Raton, P.L. CurrentSince Jul 22, 2025 Accepting new patients
Associated Family Physicians of Boca Raton, P.L. CurrentSince Feb 12, 2025 Accepting new patients

Locations

9910 Sandalfoot Blvd
Ste 1
Boca Raton, FL 33428
Phone (561) 883-3030

5266 Office Park Blvd
Ste 205
Bradenton, FL 34203
Phone (941) 202-3888

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61456

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1184359390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5266 OFFICE PARK BLVD STE 205",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342033442",
            "telephone_number": "941-202-3888",
            "fax_number": "941-236-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5266 OFFICE PARK BLVD STE 205",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342033442",
            "telephone_number": "941-202-3888",
            "fax_number": "941-236-5640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9910 Sandalfoot Blvd",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334286692",
            "country_code": "US",
            "telephone_number": "561-883-3030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENDEL",
        "first_name": "JEAN-JOSEPH",
        "middle_name": "GANEAU",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DNP, FNP-BC,PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11020837",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11020837",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184359390",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.