Individual provider Active NPI

Nadine Pierre Jean, AGPCNP

  • Nurse Practitioner
  • Greenacres, FL
National Provider Identifier
1205478955
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11004476 Issued in FL
Practice address
5333 Island Gypsy Drive
Green Acres, FL 33463
Phone
(201) 923-3124
NPI assigned
Oct 15, 2019
Last updated
Oct 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11004476 FL Primary

Addresses

Primary practice location

5333 Island Gypsy Drive
Green Acres, FL 33463

Mailing address

4151 Lake Worth Rd Unit 6545
Lake Worth, FL 33466-5058

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
I20210526000432 FL Practitioner - Nurse Practitioner 5395144273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbor Palliative Care Services, Inc.Group PAC ID 3476738527, 28 clinicians

Practice addresses (Care Compare)

5300 E Ave
West Palm Beach, FL 33407-2387
Phone (561) 227-5177

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11004476FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Palliative Care Services, Inc. CurrentSince Apr 19, 2021 Accepting new patients

Locations

5300 East Ave
West Palm Beach, FL 33407
Phone (561) 227-5177

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

Hospital & facility affiliations 1

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": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1205478955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4151 LAKE WORTH RD UNIT 6545",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334665058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 ISLAND GYPSY DRIVE",
            "city": "GREEN ACRES",
            "state": "FL",
            "postal_code": "33463",
            "telephone_number": "201-923-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE JEAN",
        "first_name": "NADINE",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11004476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

Verify at the official NPI Registry.