Individual provider Active NPI

Jessy Madhukar

  • Nurse Practitioner
  • Plantation, FL
National Provider Identifier
1578033916
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11000908 Issued in FL
Practice address
8329 W Sunrise Blvd
Plantation, FL 33322-5405
Phone
(954) 627-1617
Fax
(866) 224-5691
NPI assigned
Nov 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 11000908 FL Primary

Addresses

Primary practice location

8329 W Sunrise Blvd
Plantation, FL 33322-5405

Mailing address

8329 W Sunrise Blvd
Plantation, FL 33322-5405
Phone (954) 627-1617

Other practice location 1

8329 W Sunrise Blvd
Plantation, FL 33322-5405
Phone (954) 627-1617

Other identifiers 1

IdentifierTypeStateIssuer
F11180632MedicaidFL

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
I20190719000882 FL Practitioner - Nurse Practitioner 6901132521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.04 of 100Reported as group
Quality
65.4
Promoting interoperability
98
Improvement activities
40
Cost
76.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11000908FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro Health, LLC Multi-Specialty CurrentSince Mar 2, 2020 Accepting new patients
Advanced Medical Provider Inc Multi-Specialty Current Accepting new patients
Gastro Health LLC Multi-Specialty Current Accepting new patients
Sunshine Medical and Wellness Practice LLC Current Accepting new patients
Gastro Health, LLC Multi-Specialty CurrentSince Mar 2, 2020 Accepting new patients

Locations

4675 Linton Blvd
Ste 202
Delray Beach, FL 33445
Phone (561) 495-5700

3661 S Miami Ave
Ste 907
Miami, FL 33133
Phone (305) 856-7333

7243 Della Dr
Orlando, FL 32819
Phone (407) 381-7366

8329 W Sunrise Blvd
Plantation, FL 33322
Phone (954) 627-1617

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.

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1578033916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8329 W SUNRISE BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333225405",
            "telephone_number": "954-627-1617",
            "fax_number": "866-224-5691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8329 W SUNRISE BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333225405",
            "telephone_number": "954-627-1617",
            "fax_number": "866-224-5691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8329 W Sunrise Blvd",
            "address_purpose": "LOCATION",
            "city": "Plantation",
            "state": "FL",
            "postal_code": "333225405",
            "country_code": "US",
            "telephone_number": "954-627-1617",
            "fax_number": "866-224-5691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADHUKAR",
        "first_name": "JESSY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-28",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11000908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F11180632",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.