Individual provider Active NPI

Jean-Claude Crevecoeur, ARNP

  • Adult Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1588020010
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP9295984 Issued in FL
Practice address
1190 NW 95TH St
Miami, FL 33150-2063
Phone
(305) 835-6140
NPI assigned
Jan 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP9295984 FL Primary
Primary Care Nurse Practitioner 363LP2300X ARNP9295984 FL
Gerontology Clinical Nurse Specialist 364SG0600X ARNP9295984 FL

Addresses

Primary practice location

1190 NW 95TH St
Miami, FL 33150-2063

Mailing address

15812 SW 24TH St
Miramar, FL 33027-4267
Phone (954) 235-4872

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
I20160831002375 FL Practitioner - Nurse Practitioner 1850687732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
I and B Medical Associates IncGroup PAC ID 3971564667, 3 clinicians

Practice addresses (Care Compare)

9400 NW 12TH Ave Bay
Suite 1
Miami, FL 33150-2024
Phone (305) 835-9264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9295984FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
I & B Medical Associates Inc CurrentSince Jun 5, 2016 Accepting new patients

Locations

9400 NW 12th Ave
Ste 1
Miami, FL 33150
Phone (305) 835-9264

160 NW 170th St
North Miami Beach, FL 33169
Phone (305) 585-8957

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCFDCD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1588020010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15812 SW 24TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274267",
            "telephone_number": "954-235-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 NW 95TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331502063",
            "telephone_number": "305-835-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREVECOEUR",
        "first_name": "JEAN-CLAUDE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9295984",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9295984",
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "FL",
            "license": "ARNP9295984",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.