Individual provider Active NPI

Jeanine M Darquea, PA-C

  • Physician Assistant
  • Wellington, FL
National Provider Identifier
1285623918
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9100687 Issued in FL
Practice address
3319 S State Road 7 Ste 102
Wellington, FL 33449
Phone
(561) 333-4000
Fax
(561) 333-8851
NPI assigned
Oct 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9100687 FL Primary

Addresses

Primary practice location

3319 S State Road 7 Ste 102
Wellington, FL 33449

Mailing address

367 S. Gulph Rd
Attn: Ipm Credentialing
King of Prussia, PA 19406-3121
Phone (561) 333-4000

Other practice location 1

1021 N State Road 7
MedExpress Urgent Care
Royal Palm Beach, FL 33411-5117
Phone (561) 333-9331

Other practice location 2

13421 S Shore Blvd Ste 101
Wellington, FL 33414-7210
Phone (561) 440-1616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050228000608 FL Practitioner - Physician Assistant 6406809656 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9100687FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dwic of Tampa Bay, Inc. CurrentSince Jun 5, 2016 Accepting new patients
Medexpress Urgent Care of Boynton Beach, LLC CurrentSince Oct 22, 2017 Accepting new patients
Dwic of Tampa Bay, Inc. CurrentSince Jun 5, 2016 Accepting new patients
Dwic of Tampa Bay, Inc Past Accepting new patients
North Ridge Emergency Physicians, PA Past Accepting new patients

Locations

7593 Boynton Beach Blvd
Ste 190
Boynton Beach, FL 33437
Phone (561) 572-3200

8849 State Road 52
Hudson, FL 34667
Phone (727) 863-7150

1120 Homestead Rd N
Lehigh Acres, FL 33936
Phone (239) 303-5020

1021 N State Road 7
Royal Palm Beach, FL 33411
Phone (561) 296-5700

2810 W Mlk Blvd
Tampa, FL 33607
Phone (813) 289-6637

Organizations & group practices 7

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": "1129334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1285623918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S. GULPH RD",
            "address_2": "ATTN: IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "561-333-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 S STATE ROAD 7 STE 102",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "33449",
            "telephone_number": "561-333-4000",
            "fax_number": "561-333-8851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1021 N State Road 7",
            "address_2": "MedExpress Urgent Care",
            "address_purpose": "LOCATION",
            "city": "Royal Palm Beach",
            "state": "FL",
            "postal_code": "334115117",
            "country_code": "US",
            "telephone_number": "561-333-9331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13421 S Shore Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Wellington",
            "state": "FL",
            "postal_code": "334147210",
            "country_code": "US",
            "telephone_number": "561-440-1616",
            "fax_number": "561-440-2030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DARQUEA",
        "first_name": "JEANINE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-15",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9100687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.