Individual provider Active NPI

Jennifer Thuy Khanh Latey, PA-C

  • Medical Physician Assistant
  • Deerfield Beach, FL
National Provider Identifier
1245310770
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 9102753 Issued in FL
Practice address
750 S Federal Hwy
Deerfield Beach, FL 33441-5767
Phone
(954) 421-8181
Fax
(954) 426-2967
NPI assigned
Oct 17, 2006
Last updated
Sep 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 9102753 FL Primary

Addresses

Primary practice location

750 S Federal Hwy
Deerfield Beach, FL 33441-5767

Mailing address

10617 SW 6TH St
Pembroke Pines, FL 33025-6903
Phone (305) 788-3927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070608000382 FL Practitioner - Physician Assistant 7113025537 Reassigns benefits to 1 organization
I20170928003555 CA Practitioner - Physician Assistant 7113025537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.53 of 100Reported as group
Quality
85.33
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
54597CAMDGeneral Practice Dentistry
PA 9102753FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SC Medical, Inc. CurrentSince Aug 15, 2017 Accepting new patients
Mecnb, LLC CurrentSince Jan 1, 2007 Accepting new patients
U.S. Healthworks Medical Group of Florida, Inc. Past Accepting new patients

Locations

19042 Soledad Canyon Rd
Santa Clarita, CA 91351
Phone (661) 251-6300

750 S Federal Hwy
Deerfield Beach, FL 33441
Phone (954) 421-8181

2311 10th Ave N
Ste 14
Lake Worth, FL 33461
Phone (561) 540-4446

6515 S Kanner Hwy
Stuart, FL 34997
Phone (772) 463-1123

225 S US Highway 1
Tequesta, FL 33469
Phone (561) 747-4464

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1245310770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10617 SW 6TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330256903",
            "telephone_number": "305-788-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 S FEDERAL HWY",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334415767",
            "telephone_number": "954-421-8181",
            "fax_number": "954-426-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATEY",
        "first_name": "JENNIFER",
        "middle_name": "THUY KHANH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9102753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.