Individual provider Active NPI

Jennifer Marie Pusins, CSCD, CCC-SLP, BCS-S

  • Speech-Language Pathologist
  • Davie, FL
National Provider Identifier
1295075265
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 14201 Issued in FL
Practice address
6100 Griffin Rd
Davie, FL 33314-4416
Phone
(561) 212-5725
NPI assigned
Feb 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X
Speech-Language Pathologist 235Z00000X SA 14201 FL Primary

Addresses

Primary practice location

6100 Griffin Rd
Davie, FL 33314-4416

Mailing address

PO Box 290370
#109
Ft Lauderdale, FL 33329-0370
Phone (954) 262-4346

Other identifiers 1

IdentifierTypeStateIssuer
1030508500001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA 14201FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc Past Accepting new patients

Organizations & group practices 1

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": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1295075265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290370",
            "address_2": "#109",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333290370",
            "telephone_number": "954-262-4346",
            "fax_number": "954-262-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 GRIFFIN RD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333144416",
            "telephone_number": "561-212-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSINS",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "CSCD, CCC-SLP, BCS-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-27",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 14201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030508500001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.