Active NPI
Jennifer E Runco Therrien, M.D.
- Diagnostic Radiology Physician
- Hollywood, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- ME 123256
- Practice address
- 1005 Joe Dimaggio Dr
Hollywood, FL 33021-5402 - Phone
- (954) 265-5892
- NPI assigned
- May 8, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | ME 123256 | FL | Primary |
Addresses
Primary practice location
1005 Joe Dimaggio Dr
Hollywood, FL 33021-5402
Mailing address
500 N Hiatus Rd Ste 200
Pembroke Pines, FL 33026-5213
Phone (954) 437-4800
Other practice location 1
3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 437-4800
Other names 1
- Jennifer E Runco
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Miami Medical College, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1005 Joe Dimaggio Dr
Hollywood, FL 33021-5402
Phone (904) 399-5550
13695 US Hwy 1
Sebastian, FL 32958-3230
Phone (904) 399-5550
2713 NE 14TH St
Fort Lauderdale, FL 33304-1610
Phone (904) 339-5550
3501 Johnson St
Hollywood, FL 33021-5421
Phone (904) 399-5550
7800 Sheridan St
Pembroke Pines, FL 33024-2536
Phone (904) 399-5550
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 123256 | FL | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mori Bean and Brooks Inc | Diagnostic Radiology | Current | Accepting new patients |
Locations
1005 N 35th Ave
Hollywood, FL 33021
Phone (954) 265-5324
2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015
3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000
500 N Hiatus Rd
Ste 200
Pembroke Pines, FL 33026
Phone 9544374800 ext. 2133
13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185
2115 Little Rd
Trinity, FL 34655
Phone 7278418225410
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.
-
- Diagnostic Radiology Physician
- Tampa, FL
- NPI 1093782070
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Pembroke Pines, FL
- NPI 1063495836
-
- General Acute Care Hospital
- Pembroke Pines, FL
- NPI 1134102080
-
- General Acute Care Hospital
- Hollywood, FL
- NPI 1780667923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649376000000",
"number": "1407080195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 N HIATUS RD STE 200",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330265213",
"telephone_number": "954-437-4800",
"fax_number": "954-437-6628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 JOE DIMAGGIO DR",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330215402",
"telephone_number": "954-265-5892"
}
],
"practiceLocations": [
{
"address_1": "3501 Johnson St",
"address_purpose": "LOCATION",
"city": "Hollywood",
"state": "FL",
"postal_code": "330215421",
"country_code": "US",
"telephone_number": "954-437-4800",
"fax_number": "954-437-6628",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUNCO THERRIEN",
"first_name": "JENNIFER",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-08",
"last_updated": "2022-04-08",
"certification_date": "2022-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "ME 123256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "RUNCO",
"middle_name": "E",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.
- 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.