Individual provider Active NPI

Melissa Johnston, DNP

  • Gerontology Nurse Practitioner
  • Plantation, FL
National Provider Identifier
1346836095
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
11010033 Issued in FL
Practice address
350 NW 84TH Ave Ste 110
Plantation, FL 33324-1847
Phone
(954) 678-9531
NPI assigned
Dec 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 11010033 FL Primary

Addresses

Primary practice location

350 NW 84TH Ave Ste 110
Plantation, FL 33324-1847

Mailing address

350 NW 84TH Ave Ste 110
Plantation, FL 33324-1847
Phone (954) 678-9531

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
I20210610002041 FL Practitioner - Nurse Practitioner 7810397999 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiac Arrhythmia Service IncGroup PAC ID 7618873555, 6 clinicians

Practice addresses (Care Compare)

1200 N Federal Hwy
Suite 100
Boca Raton, FL 33432-2844
Phone (561) 266-0190

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11010033FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Heart Rhythm Specialists PLLC CurrentSince May 4, 2021 Accepting new patients
David N Kenigsberg MD PA PastSince Dec 22, 2020 Accepting new patients

Locations

2307 W Broward Blvd
Ste 102
Fort Lauderdale, FL 33312
Phone (954) 820-4200

1841 NE 45th St
Ft Lauderdale, FL 33308
Phone (954) 820-4200

2825 N State Road 7
Ste 303
Margate, FL 33063
Phone (954) 820-4200

350 NW 84th Ave
Ste 110
Plantation, FL 33324
Phone (954) 820-4200

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18048/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1346836095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NW 84TH AVE STE 110",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241847",
            "telephone_number": "954-678-9531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 NW 84TH AVE STE 110",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241847",
            "telephone_number": "954-678-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "MELISSA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11010033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.