Summer Lynn Divincenzo, ARNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

ARNP9254933 Issued in FL

Practice address

4430 Sheridan St Ste B
Hollywood, FL 33021-3546

Phone

(954) 963-5437

NPI assigned

Oct 18, 2017

Last updated

Jul 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Florida Em-I Medical Services, PA

  • Nurse Practitioner
  • Fort Lauderdale, FL
  • NPI 1316764988
  Medicare reassignment NPD
• Florida Em-I Medical Services, PA

  • Nurse Practitioner
  • Coral Springs, FL
  • NPI 1336966910
  NPD
• Hollywood Pediatrics, P.a.

  • Specialist
  • Hollywood, FL
  • NPI 1285840900
  NPD (past)

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1366953242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5851 HOLMBERG RD APT 2011",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330674525",
            "telephone_number": "954-415-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 SHERIDAN ST STE B",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213546",
            "telephone_number": "954-963-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 SW 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331553009",
            "country_code": "US",
            "telephone_number": "305-666-6511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIVINCENZO",
        "first_name": "SUMMER",
        "middle_name": "LYNN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9254933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE NUMBER",
            "identifier": "ARNP9254933",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Traci Celeste Diphillippo, PA-C
• Diplomat Orthopaedic Group PA
• Dishmey-Health LLC
• Nicholas Distefano
• Jordan Ditchek, M.D.
• Divine Motion Chiropractic LLC
• Desi Dixon, LCSW
• Donald Fitzherbert Dixon, MD
• Tamara Tricia Dixon, ARNP
• DK MD, Inc.

• Pediatric Nurse Practitioner in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.