Active NPI
Kybuki K. Reid, ARNP
- Family Nurse Practitioner
- Miramar, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN11030011
- Practice address
- 4979 SW 164TH Ave
Miramar, FL 33027-4948 - Phone
- (954) 610-0861
- NPI assigned
- Dec 5, 2023
- Last updated
- Dec 5, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11030011 | FL | Primary |
Addresses
Primary practice location
4979 SW 164TH Ave
Miramar, FL 33027-4948
Mailing address
4979 SW 164TH Ave
Miramar, FL 33027-4948
Phone (954) 610-0861
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11030011 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urgent Medical Center Inc | Current | Accepting new patients | |
| Multiviz Medical Services PC | Current | Accepting new patients | |
| Chiro Worx Injury Center Inc | Current | Accepting new patients | |
| Rockaway HD LLC | Past | Accepting new patients |
Locations
7300 Del Prado Cir S
Boca Raton, FL 33433
Phone (561) 392-3000
6931 W Broward Blvd
Plantation, FL 33317
Phone (954) 321-5191
529 Beach 20th St
Far Rockaway, NY 11691
Phone (516) 770-5712
529 Beach 20th St
Ste 1
Far Rockaway, NY 11691
Phone (718) 327-4503
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Plantation Nursing & Rehabilitation Center | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Apr 12, 2022 Apr 12, 2022 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Skilled Nursing Facility
- Plantation, FL
- NPI 1487681656
Adp of the SNF, Operational/Managerial Control
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Urgent Care Clinic/Center
- Plantation, FL
- NPI 1609098250
-
- Primary Care Clinic/Center
- Plantation, FL
- NPI 1801524459
-
dba Rockaway Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Far Rockaway, NY
- NPI 1194085662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1417724089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4979 SW 164TH AVE",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330274948",
"telephone_number": "954-610-0861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4979 SW 164TH AVE",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330274948",
"telephone_number": "954-610-0861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REID",
"first_name": "KYBUKI",
"middle_name": "K.",
"credential": "ARNP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-12-05",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11030011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.