Individual provider Active NPI

Priya Sivakumar Nair

  • Family Nurse Practitioner
  • Cooper City, FL
National Provider Identifier
1396461760
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11037008 Issued in FL
Practice address
5204 SW 87TH Ave
Cooper City, FL 33328-4330
Phone
(301) 980-1133
NPI assigned
Oct 17, 2022
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11037008 FL Primary
Wound Care Registered Nurse 163WW0000X 9361867 FL

Addresses

Primary practice location

5204 SW 87TH Ave
Cooper City, FL 33328-4330

Mailing address

5204 SW 87TH Ave
Cooper City, FL 33328-4330
Phone (301) 980-1133

Other identifiers 1

IdentifierTypeStateIssuer
N600-677-72-010-0OtherFLDRIVERS LISENCE

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
I20250212002376 FL Practitioner - Nurse Practitioner 8527598051 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Masson Medical Specialist CorporationGroup PAC ID 6103284849, 5 clinicians

Practice addresses (Care Compare)

10756 NW 20TH Dr
Coral Springs, FL 33071-4215
Phone (954) 849-6566

5204 SW 87TH Ave
Cooper City, FL 33328-4330
Phone (301) 980-1133

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9361867FLMDWound Care Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Masson Medical Specialist Corporation Wound Care CurrentSince Jan 16, 2025 Accepting new patients
123Wounds LLC CurrentSince Dec 21, 2025 Accepting new patients

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": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1396461760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5204 SW 87TH AVE",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333284330",
            "telephone_number": "301-980-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5204 SW 87TH AVE",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333284330",
            "telephone_number": "301-980-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIR",
        "first_name": "PRIYA",
        "middle_name": "SIVAKUMAR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11037008",
            "primary": true
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "FL",
            "license": "9361867",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LISENCE",
            "identifier": "N600-677-72-010-0",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooper City, FL

Sources for this page

Verify at the official NPI Registry.