Individual provider Active NPI

Cheryl Kushner, APRN

  • Pediatric Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1356351167
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1950132 Issued in FL
Practice address
1131 N 35TH Ave Ste 330
Hollywood, FL 33021
Phone
(954) 265-6333
Fax
(954) 265-6336
NPI assigned
Aug 8, 2006
Last updated
Mar 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1950132 FL Primary

Addresses

Primary practice location

1131 N 35TH Ave Ste 330
Hollywood, FL 33021

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Other identifiers 1

IdentifierTypeStateIssuer
303167500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ckushner9535@MHSDIRECT.NET Direct

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
I20080710000771 FL Practitioner - Nurse Practitioner 2365514148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

1131 N 35TH Ave
Hollywood, FL 33021-5403

4651 Sheridan St
Suite 150
Hollywood, FL 33021-3443
Phone (954) 265-6331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1950132FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Dec 25, 2017 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

Interoperability endpoints

  • Direct secure messaging: ckushner9535@mhsdirect.net

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, 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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1356351167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 N 35TH AVE STE 330",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-265-6333",
            "fax_number": "954-265-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSHNER",
        "first_name": "CHERYL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "1950132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303167500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckushner9535@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1131 N 35th Ave Ste 330",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.