Individual provider Active NPI

Gary E Jett, MD

  • Physical Medicine & Rehabilitation Physician
  • Miami, FL
National Provider Identifier
1457390098
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
1084 Issued in VI
Practice address
619 NW 12TH Ave
Miami, FL 33136-3609
Phone
(305) 821-5119
Fax
(305) 227-1684
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 1084 VI Primary

Addresses

Primary practice location

619 NW 12TH Ave
Miami, FL 33136-3609

Mailing address

619 NW 12TH Ave
Miami, FL 33136
Phone (305) 821-5119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100111000800 VI Practitioner - Physical Medicine and Rehabilitation 0749321891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Wayne State University School of Medicine, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10572 Barren Spot
Suite 7
Kingshill, VI 00850-9664
Phone (340) 718-8282

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Chiropractic LLC PastSince Aug 31, 2013 Accepting new patients

Organizations & group practices 2

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1457390098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33136",
            "telephone_number": "305-821-5119",
            "fax_number": "305-227-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331363609",
            "telephone_number": "305-821-5119",
            "fax_number": "305-227-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETT",
        "first_name": "GARY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VI",
            "license": "1084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.