Individual provider Active NPI

Petar Jen, DO

  • Emergency Medicine Physician
  • Aventura, FL
National Provider Identifier
1578265997
Registry record updated Jul 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
W5391 Issued in TX
Practice address
20900 Biscayne Blvd
Aventura, FL 33180-1407
Phone
(305) 692-3468
NPI assigned
Mar 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X W5391 TX Primary

Addresses

Primary practice location

20900 Biscayne Blvd
Aventura, FL 33180-1407

Mailing address

20900 Biscayne Blvd
Aventura, FL 33180-1407
Phone (941) 661-4269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260604001653 TX Practitioner - Emergency Medicine 5597127019

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Florida State University College of Medicine, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2300 Sandy Pine Dr
Punta Gorda, FL 33982-9640

5000 Hopyard Rd
Pleasanton, CA 94588-3145

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783728000000",
    "number": "1578265997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20900 BISCAYNE BLVD",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801407",
            "telephone_number": "941-661-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20900 BISCAYNE BLVD",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801407",
            "telephone_number": "305-692-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEN",
        "first_name": "PETAR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-07-11",
        "certification_date": "2026-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "W5391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.