Individual provider Active NPI

Kybuki K. Reid, ARNP

  • Family Nurse Practitioner
  • Miramar, FL
National Provider Identifier
1417724089
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11030011 Issued in FL
Practice address
4979 SW 164TH Ave
Miramar, FL 33027-4948
Phone
(954) 610-0861
NPI assigned
Dec 5, 2023
Last updated
Dec 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250423000737 FL Practitioner - Nurse Practitioner 8325316391 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11030011FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Medical Center Inc CurrentSince Nov 11, 2025 Accepting new patients
Multiviz Medical Services PC CurrentSince Feb 8, 2025 Accepting new patients
Chiro Worx Injury Center Inc CurrentSince Nov 11, 2025 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.

FacilityTypeRoleSince
Plantation Nursing & Rehabilitation CenterPlantation, FL, CCN 105175 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.

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.

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

Verify at the official NPI Registry.