Kensy Chavez, APRN FNP-C

Individual provider Active NPI Family Nurse Practitioner · Wilton Manors, FL

NPI 1457084436 · NPPES record last updated Mar 7, 2024

Key facts

NPI
1457084436
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
11020637 (FL)
Practice address
1401 NE 26TH St
Wilton Manors, FL 33305-1321
Phone
(954) 765-6239
Fax
(954) 827-7780
NPI assigned
Jul 6, 2022
Sex
Male
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1401 NE 26TH St
Wilton Manors, FL 33305-1321

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230424003080 FL Practitioner - Nurse Practitioner 5597135269 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11020637FLMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: kensy.chavez.1@26676.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/26676/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LF0000X 11020637 FL Yes

Addresses

Primary practice location

1401 NE 26TH St
Wilton Manors, FL 33305-1321

Mailing address

739 NW 112TH St
Miami, FL 33168-2240

Other providers in Wilton Manors, FL

All providers in Wilton Manors, FL · Family Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.