Individual provider Active NPI

Nicole M. Lavin, APRN

  • Nurse Practitioner
  • Pompano Beach, FL
National Provider Identifier
1366866485
Registry record updated Nov 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9309250 Issued in FL
Practice address
1 W Sample Road
Pompano Beach, FL 33064
Phone
(854) 204-5949
NPI assigned
Feb 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 363L00000X PA
Nurse Practitioner 363L00000X ARNP9309250 FL Primary

Addresses

Primary practice location

1 W Sample Road
Pompano Beach, FL 33064

Mailing address

9900 NW 38TH St
Coral Springs, FL 33065-2830
Phone (954) 464-1694

Other practice location 1

2004 Mowry Rd
Gainesville, FL 32610-3033
Phone (352) 294-5800

Other practice location 2

5360 Saltsburg Rd
Verona, PA 15147-3033
Phone (412) 864-2911

Other identifiers 1

IdentifierTypeStateIssuer
022317100MedicaidFL

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
I20171031001227 FL Practitioner - Nurse Practitioner 3779808316 Reassigns benefits to 1 organization

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)

1600 SW Archer
Gainesville, FL 32610-3003

1600 SW Archer Rd
Gainesville, FL 32610-3003

1600 SW Archer Rd RM
1191 Uf Health Surgical Specialists Shands
Gainesville, FL 32610-3003
Phone (352) 265-0535

2000 SW Archer Rd
Uf Health Congenital Heart Center Medical P
Gainesville, FL 32610-3003
Phone (352) 265-8250

2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990

4197 NW 86TH Ter
Gainesville, FL 32606-9278
Phone (352) 273-9400

4197 NW 86TH Terr 1St Floor
Gainesville, FL 32606-9278

Uf Health Test Site Pop Up 1600 SW Ar
Gainesville, FL 32610-3003
Phone (352) 392-1161

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9309250FLMDNurse Practitioner
363L00000XPAMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: nconnell11735@direct.shands.ufl.edu

Organizations & group practices 1

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 8

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": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636156800000",
    "number": "1366866485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 NW 38TH ST",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330652830",
            "telephone_number": "954-464-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W SAMPLE ROAD",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "33064",
            "telephone_number": "854-204-5949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2004 Mowry Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103033",
            "country_code": "US",
            "telephone_number": "352-294-5800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5360 Saltsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Verona",
            "state": "PA",
            "postal_code": "151473033",
            "country_code": "US",
            "telephone_number": "412-864-2911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVIN",
        "first_name": "NICOLE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-10",
        "last_updated": "2021-11-06",
        "certification_date": "2021-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "363L00000X",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9309250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022317100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.