Individual provider Active NPI

Katherine Reyes Prendes, ARNP,PNP-BC

  • Pediatric Nurse Practitioner
  • Plantation, FL
National Provider Identifier
1417183195
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP9235678 Issued in FL
Practice address
499 NW 70TH Ave Ste 200
Plantation, FL 33317-7578
Phone
(954) 223-5483
Fax
(954) 223-5484
NPI assigned
Jun 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP9235678 FL Primary

Addresses

Primary practice location

499 NW 70TH Ave Ste 200
Plantation, FL 33317-7578

Mailing address

499 NW 70TH Ave Ste 200
Plantation, FL 33317-7578
Phone (954) 223-5483

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
I20200130001798 FL Practitioner - Nurse Practitioner 3476989021 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elite Spine and Wellness, LLCGroup PAC ID 1456738822, 4 clinicians

Practice addresses (Care Compare)

499 NW 70TH Ave
Suite 200
Plantation, FL 33317-7578
Phone (954) 223-5483

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9235678FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Plan B Therapy Inc. CurrentSince Sep 7, 2024 Accepting new patients
Tenet Florida Physician Services II, LLC Pediatrics CurrentSince Jan 13, 2020 Accepting new patients
Elite Spine and Wellness, LLC CurrentSince Jul 3, 2022 Accepting new patients
Tenet Florida Physician Services II, LLC CurrentSince Jan 13, 2020 Accepting new patients

Locations

3000 Bayview Dr
Ft Lauderdale, FL 33306
Phone (954) 393-1708

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

499 NW 70th Ave
Ste 200
Plantation, FL 33317
Phone (954) 223-5483

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1417183195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 NW 70TH AVE STE 200",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333177578",
            "telephone_number": "954-223-5483",
            "fax_number": "954-223-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 NW 70TH AVE STE 200",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333177578",
            "telephone_number": "954-223-5483",
            "fax_number": "954-223-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDES",
        "first_name": "KATHERINE",
        "middle_name": "REYES",
        "name_prefix": "Mrs.",
        "credential": "ARNP,PNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9235678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.