Individual provider Active NPI

Adrienne Lightbourne, MD

  • Pediatric Cardiology Physician
  • Pembroke Pines, FL
National Provider Identifier
1407221740
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
ME181858 Issued in FL
Practice address
12295 Taft St
Pembroke Pines, FL 33026-1900
Phone
(954) 447-7774
NPI assigned
Dec 12, 2015
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X ME181858 FL Primary

Addresses

Primary practice location

12295 Taft St
Pembroke Pines, FL 33026-1900

Mailing address

12295 Taft St
Pembroke Pines, FL 33026-1900
Phone (954) 447-7774

Other practice location 1

3801 Hollywood Blvd Ste 350
Hollywood, FL 33021-6762
Phone (954) 876-9535

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220914000416 CA Practitioner - Pediatric Medicine 3577978386 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A177293CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince Jun 30, 2022 Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Jun 30, 2022 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 30, 2022 Accepting new patients
University of California San Francisco CurrentSince Jun 30, 2022 Accepting new patients
University of California San Francisco Pediatrics CurrentSince Jun 30, 2022 Accepting new patients

Locations

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

2001 The Embarcadero
Ste 1500
San Francisco, CA 94143
Phone (415) 353-1606

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

Interoperability endpoints

  • Direct secure messaging: alightbourne107061@direct-ucsfmedicalcenter.org

Organizations & group practices 5

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": "1449878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1407221740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12295 TAFT ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330261900",
            "telephone_number": "954-447-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12295 TAFT ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330261900",
            "telephone_number": "954-447-7774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Hollywood Blvd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330216762",
            "country_code": "US",
            "telephone_number": "954-876-9535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIGHTBOURNE",
        "first_name": "ADRIENNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-12",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME181858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.