Individual provider Active NPI

Marie Rose Samuela Jasmin, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Coral Springs, FL
National Provider Identifier
1336544733
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN9294753 Issued in FL
Practice address
1500 N University Drive
Suite 202
Coral Springs, FL 33071
Phone
(954) 350-0747
NPI assigned
Oct 28, 2014
Last updated
Sep 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 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 9294753 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN9294753 FL Primary

Addresses

Primary practice location

1500 N University Drive
Suite 202
Coral Springs, FL 33071

Mailing address

1500 N University Dr Ste 202
Coral Springs, FL 33071-6072
Phone (954) 350-0747

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
I20160323000466 FL Practitioner - Nurse Practitioner 6103146840 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3160 Powerline Rd
Oakland Park, FL 33309-5911
Phone 3055761234282

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9294753FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South County Mental Health Center, Inc. CurrentSince Dec 2, 2015 Accepting new patients
Care Resource Community Health Centers, Inc Current Accepting new patients
Care Resource Community Health Centers, Inc CurrentSince Aug 7, 2023 Accepting new patients
Care Resource Community Health Centers, Inc. CurrentSince Aug 7, 2023 Accepting new patients
One Place Psychiatric Care LLC Psychiatric/Mental Health Current Accepting new patients
Luis Hines & Associates, PA Psychiatric/Mental Health CurrentSince Feb 29, 2020 Accepting new patients
O Yes Medical Services Inc. PastSince Feb 29, 2020 Accepting new patients
Care Resource Community Health Centers, Inc. Past Accepting new patients

Locations

1500 N University Dr
Ste 202
Coral Springs, FL 33071
Phone (954) 350-0747

16158 S Military Trl
Delray Beach, FL 33484
Phone (561) 495-0522

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

3510 Biscayne Blvd
Miami, FL 33137
Phone 3055761234282

1680 Michigan Ave
Ste 912
Miami Beach, FL 33139
Phone (305) 534-0503

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

3160 Powerline Rd
Oakland Park, FL 33309
Phone (305) 773-7844

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

871 W Oakland Park Blvd
Wilton Manors, FL 33311
Phone (954) 567-7141

Interoperability endpoints

  • Direct secure messaging: marierose.jasmin.p1@direct.careresource.nextgenshare.com

Organizations & group practices 8

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": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1336544733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N UNIVERSITY DR STE 202",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330716072",
            "telephone_number": "954-350-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N UNIVERSITY DRIVE",
            "address_2": "SUITE 202",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33071",
            "telephone_number": "954-350-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASMIN",
        "first_name": "MARIE ROSE",
        "middle_name": "SAMUELA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9294753",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9294753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.