Individual provider Active NPI

Sandina Samantha Jackson, APRN

  • Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1225623408
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11010356 Issued in FL
Practice address
880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171
Phone
(866) 849-0692
NPI assigned
Mar 9, 2021
Last updated
May 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5023920 NC
Nurse Practitioner 363L00000X GAA-NP004965 GA
Nurse Practitioner 363L00000X 31804 SC
Nurse Practitioner 363L00000X SP035423 PA
Nurse Practitioner 363L00000X APRN11010356 FL Primary

Addresses

Primary practice location

880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171

Mailing address

1000 36TH St
Vero Beach, FL 32960-4862

Other practice location 1

1000 36th St
Vero Beach, FL 32960-4862
Phone (772) 567-4311

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
I20210428001211 FL Practitioner - Nurse Practitioner 9234547407 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

514 SE Port St Lucie Blvd
Port Saint Lucie, FL 34984-5108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11010356FLMDNurse Practitioner
GAA-NP004965GAMDNurse Practitioner
5023920NCMDNurse Practitioner
SP035423PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jupiter Medical Center Physicians Group CurrentSince Jun 5, 2023 Accepting new patients
Jupiter Medical Center Physicians Group Inc CurrentSince Jun 5, 2023 Accepting new patients
Jupiter Medical Center Physicians Group Inc Current Accepting new patients
Metcare of Florida, Inc CurrentSince Jul 18, 2024 Accepting new patients
Conviva Medical Center Management LLC CurrentSince Aug 26, 2024 Accepting new patients
Metcare of Florida, Inc CurrentSince Jul 18, 2024 Accepting new patients

Locations

6221 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 491-1686

440 W 49th St
Hialeah, FL 33012
Phone (305) 828-5000

1002 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 741-5695

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

1700 SE Hillmoor Dr
Ste 500
Port St Lucie, FL 34952
Phone (772) 335-3200

514 SE Port St Lucie Blvd
Port St Lucie, FL 34984
Phone (772) 871-5900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FJEICA
  • Direct secure messaging: sandina.jackson.1@29601.direct.athenahealth.com
  • Direct secure messaging: sandina.jackson.p1@direct.alegiscare.nextgenshare.com
  • Direct secure messaging: sandina.jackson.p2@direct.alegiscare.nextgenshare.com

Organizations & group practices 6

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": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1225623408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 36TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 SW 145TH AVE STE 202",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330276171",
            "telephone_number": "866-849-0692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 36th St",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329604862",
            "country_code": "US",
            "telephone_number": "772-567-4311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SANDINA",
        "middle_name": "SAMANTHA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-09",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5023920",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "GAA-NP004965",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "31804",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP035423",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11010356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.