Individual provider Active NPI

Agnes A Narikkattu

  • Psychiatric/Mental Health Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1235535030
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
9358568 Issued in FL
Practice address
1931 NW 150TH Ave Ste 278
Pembroke Pines, FL 33028-2885
Phone
(954) 406-5220
Fax
(754) 484-3904
NPI assigned
Nov 6, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 9358568 FL Primary
Nurse Practitioner 363L00000X ARNP 9358568 FL

Addresses

Primary practice location

1931 NW 150TH Ave Ste 278
Pembroke Pines, FL 33028-2885

Mailing address

1931 NW 150TH Ave Ste 278
Pembroke Pines, FL 33028-2885
Phone (954) 406-5220

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
I20230223002998 FL Practitioner - Nurse Practitioner 3779956602 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Florida International Univ, College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J and G Medical Associates PAGroup PAC ID 2860700408, 3 clinicians

Practice addresses (Care Compare)

5821 NW 28TH St
Lauderhill, FL 33313-2333
Phone (954) 777-0038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 9358568FLMDNurse Practitioner
9358568FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Luis Hines & Associates, PA Psychiatric/Mental Health CurrentSince Jul 17, 2023 Accepting new patients
A & B Medical Integrated Care Inc Psychiatric/Mental Health CurrentSince Aug 4, 2024 Accepting new patients
J & G Medical Associates PA Psychiatric/Mental Health CurrentSince Feb 7, 2023 Accepting new patients
O Yes Medical Services Inc. PastSince Jul 17, 2023 Accepting new patients

Locations

8958 W State Road 84
Davie, FL 33324
Phone (754) 777-0917

4200 Washington St
Hollywood, FL 33021
Phone (954) 981-6300

5821 NW 28th St
Lauderhill, FL 33313
Phone (954) 771-0038

2828 Coral Way
Ste 460
Miami, FL 33145
Phone (305) 642-5255

12550 Biscayne Blvd
Ste 306
North Miami, FL 33181
Phone (305) 895-0504

5401 S Kirkman Rd
Ste 310
Orlando, FL 32819
Phone (305) 895-0504

1931 NW 150th Ave
Ste 278
Pembroke Pines, FL 33028
Phone (954) 406-5220

Organizations & group practices 4

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": "1415232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1235535030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 NW 150TH AVE STE 278",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282885",
            "telephone_number": "954-406-5220",
            "fax_number": "754-484-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 NW 150TH AVE STE 278",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282885",
            "telephone_number": "954-406-5220",
            "fax_number": "754-484-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARIKKATTU",
        "first_name": "AGNES",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-06",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9358568",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 9358568",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.