Individual provider Active NPI

Kendy Jean

  • Family Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1548015860
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11055803 Issued in FL
Practice address
4200 Washington St
Hollywood, FL 33021-7353
Phone
(954) 981-6300
NPI assigned
Apr 19, 2024
Last updated
Apr 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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 APRN11055803 FL Primary

Addresses

Primary practice location

4200 Washington St
Hollywood, FL 33021-7353

Mailing address

1909 SW 11TH St
Fort Lauderdale, FL 33312-3209
Phone (954) 297-4765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250307002996 FL Practitioner - Nurse Practitioner 3779004692
I20250319002228 NY Practitioner - Nurse Practitioner 3779004692 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11055803FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brookview Medical Associates, PLLC CurrentSince Jan 12, 2025 Accepting new patients

Locations

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

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, 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": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1548015860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 SW 11TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333123209",
            "telephone_number": "954-297-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 WASHINGTON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330217353",
            "telephone_number": "954-981-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "KENDY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11055803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.