Individual provider Active NPI

Marea Kefalas

  • Family Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1497280341
Registry record updated Jul 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9295476 Issued in FL
Practice address
3501 Johnson St
MRH Total Heart Center
Hollywood, FL 33021-5421
Phone
(954) 265-7750
NPI assigned
Apr 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2017

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 ARNP9295476 FL Primary

Addresses

Primary practice location

3501 Johnson St
MRH Total Heart Center
Hollywood, FL 33021-5421

Mailing address

2900 Corporate Way
Door D
Hollywood, FL 33021-3925
Phone (954) 276-5685

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
I20170908001161 FL Practitioner - Nurse Practitioner 6204109515 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, shared by 55 NPIs, 659 clinicians

Practice addresses (Care Compare)

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-7750

Hospital & facility affiliations

  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Jun 25, 2017 Accepting new patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District CurrentSince Jun 25, 2017 Accepting new patients
South Broward Hospital District CurrentSince Sep 15, 2020 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

3501 Johnson St
Fl 1
Hollywood, FL 33021
Phone (954) 265-7750

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

4651 Sheridan St
Ste 150
Pembroke Park, FL 33021
Phone (954) 265-6331

801 N Flamingo Rd
Pembroke Pines, FL 33028
Phone (954) 844-6868

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500076800000",
    "number": "1497280341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213925",
            "telephone_number": "954-276-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "address_2": "MRH TOTAL HEART CENTER",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-265-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEFALAS",
        "first_name": "MAREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2017-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9295476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.