Individual provider Active NPI

Jared Dykes, APRN

  • Family Nurse Practitioner
  • Palm Bay, FL
National Provider Identifier
1346911500
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11015629 Issued in FL
Practice address
5270 Babcock St NE Ste 1
Palm Bay, FL 32905-4616
Phone
(321) 722-5959
NPI assigned
Sep 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9304261 FL
Family Nurse Practitioner 363LF0000X APRN11015629 FL Primary

Addresses

Primary practice location

5270 Babcock St NE Ste 1
Palm Bay, FL 32905-4616

Mailing address

PO Box 1137
Melbourne, FL 32902-1137
Phone (321) 952-9696

Other identifiers 1

IdentifierTypeStateIssuer
APRN11015629OtherFLMEDICAL LICENSE

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
I20230522002449 FL Practitioner - Nurse Practitioner 0648657593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brevard Physician Associates PLLCGroup PAC ID 1850535048, 221 clinicians

Practice addresses (Care Compare)

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-7000

Hospital & facility affiliations

  • Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
  • Viera Hospital Hospital, Melbourne, FL, CCN 100315
  • Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177
  • Palm Bay Hospital Hospital, Palm Bay, FL, CCN 100316

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9304261FLMDRegistered Nurse
APRN11015629FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Physician Associates, PLLC CurrentSince Jun 1, 2023 Accepting new patients
Orlando Health Medical Group Inc Past Accepting new patients

Locations

1775 W Hibiscus Blvd
Ste 215
Melbourne, FL 32901
Phone (321) 255-9671

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

Interoperability endpoints

  • Direct secure messaging: jdykes70431@epicdirect.hf.org

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1346911500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329021137",
            "telephone_number": "321-952-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5270 BABCOCK ST NE STE 1",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329054616",
            "telephone_number": "321-722-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKES",
        "first_name": "JARED",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9304261",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11015629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "APRN11015629",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.