Individual provider Active NPI

Rita Sereke Gaim, ARNP

  • Family Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1285120873
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11017581 Issued in FL
Practice address
1685 S State Road 7 Ste 4
Hollywood, FL 33023-6721
Phone
(954) 758-4429
NPI assigned
Jul 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP134682 TX
Family Nurse Practitioner 363LF0000X 11017581 FL Primary

Addresses

Primary practice location

1685 S State Road 7 Ste 4
Hollywood, FL 33023-6721

Mailing address

1081 NW 55TH St
Miami, FL 33127-1829
Phone (954) 600-8270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 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
I20210218000732 TX Practitioner - Nurse Practitioner 1456766708 Reassigns benefits to 1 organization
I20241202000373 FL Practitioner - Nurse Practitioner 1456766708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Villagehealth DM LLCGroup PAC ID 2769812445, 161 clinicians

Practice addresses (Care Compare)

1382 Lomaland Dr
Suite B
El Paso, TX 79935-5204
Phone (915) 633-1018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11017581FLMDFamily Nurse Practitioner
AP134682TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation for Sickle Cell Disease Research CurrentSince Aug 12, 2024 Accepting new patients

Locations

1685 S State Road 7
Ste 4
Hollywood, FL 33023
Phone (954) 459-4600

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFEDDD

Organizations & group practices 2

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": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1285120873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 NW 55TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331271829",
            "telephone_number": "954-600-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 S STATE ROAD 7 STE 4",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330236721",
            "telephone_number": "954-758-4429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAIM",
        "first_name": "RITA",
        "middle_name": "SEREKE",
        "name_prefix": "Miss",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP134682",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11017581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.