Active NPI
Sandina Samantha Jackson, APRN
- Nurse Practitioner
- Pembroke Pines, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN11010356
- 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, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11010356 | FL | MD | Nurse Practitioner |
| GAA-NP004965 | GA | MD | Nurse Practitioner |
| 5023920 | NC | MD | Nurse Practitioner |
| SP035423 | PA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jupiter Medical Center Physicians Group | Current | Accepting new patients | |
| Jupiter Medical Center Physicians Group Inc | Current | Accepting new patients | |
| Jupiter Medical Center Physicians Group Inc | Current | Accepting new patients | |
| Metcare of Florida, Inc | Current | Accepting new patients | |
| Conviva Medical Center Management LLC | Current | Accepting new patients | |
| Metcare of Florida, Inc | Current | 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
- https://fhir4.healow.com/fhir/r4/FJEICA
- sandina.jackson.1@29601.direct.athenahealth.com
- sandina.jackson.p1@direct.alegiscare.nextgenshare.com
- 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.
-
dba Conviva Care Center
- Internal Medicine Physician
- Miami, FL
- NPI 1649324278
-
- Cardiovascular Disease Physician
- Jupiter, FL
- NPI 1396992475
-
dba Conviva Care Center
- Internal Medicine Physician
- Hialeah, FL
- NPI 1902893225
-
dba Jupiter Medical Center Urgent Care
- Urgent Care Clinic/Center
- Jupiter, FL
- NPI 1013314285
-
dba JMC Community Care
- Pediatric Surgery Physician
- Jupiter, FL
- NPI 1093344376
-
dba Conviva Care Center
- Internal Medicine Physician
- Port Orange, FL
- NPI 1619433869
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.