Organization Active NPI

Dr Wentworth Jarrett PA

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1366637951
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DR WENTWORTH JARRETT PA
Practice address
12955 SW 132ND St
BLDG 3B Suite 104
Miami, FL 33186-7205
Phone
(305) 520-5750
Fax
(305) 520-5754
NPI assigned
Sep 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Authorized official

Name
Dr. Wentworth G Jarrett, M.D.NPI 1104836972
Title
Owner
Phone
(305) 520-5750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

12955 SW 132ND St
BLDG 3B Suite 104
Miami, FL 33186-7205

Mailing address

12955 SW 132ND St
BLDG 3B Suite 104
Miami, FL 33186-7205
Phone (305) 520-5750

Other identifiers 3

IdentifierTypeStateIssuer
D20890OtherFLUPIN
046128800MedicaidFL
04162OtherFLBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080612000256 FL Part B Supplier - Clinic/Group Practice 9830260249 Receives reassigned benefits from 3 practitioners
Practice locations: Miami, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0870102Dr Wentworth Jarrett, PA12955 SW 132ND Street, Miami, FL 33186Certificate of waiverOct 19, 2027

National Provider Directory

National Provider Directory

Locations

12955 SW 132nd St
Ste 104
Miami, FL 33186
Phone (305) 253-4340

12955 SW 132nd St
Bldg 3B
Miami, FL 33186
Phone (305) 253-4340

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACHCCD

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1366637951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12955 SW 132ND ST",
            "address_2": "BLDG 3B SUITE 104",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331867205",
            "telephone_number": "305-520-5750",
            "fax_number": "305-520-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12955 SW 132ND ST",
            "address_2": "BLDG 3B SUITE 104",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331867205",
            "telephone_number": "305-520-5750",
            "fax_number": "305-520-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR WENTWORTH JARRETT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "JARRETT",
        "authorized_official_first_name": "WENTWORTH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-520-5750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "D20890",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046128800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "04162",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.