Individual provider Active NPI

Jenny Tepler

  • Physician Assistant
  • Miami Beach, FL
National Provider Identifier
1609541598
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
026435 Issued in NY
Practice address
4465 N Michigan Ave
Miami Beach, FL 33140-2958
Phone
(786) 201-4773
NPI assigned
Aug 12, 2021
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 026435 NY Primary

Addresses

Primary practice location

4465 N Michigan Ave
Miami Beach, FL 33140-2958

Mailing address

4465 N Michigan Ave
Miami Beach, FL 33140-2958
Phone (786) 201-4773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20221206000742 NY Practitioner - Physician Assistant 0042689572 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 1, 2022 Accepting new patients

Organizations & group practices 3

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": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1609541598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 N MICHIGAN AVE",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402958",
            "telephone_number": "786-201-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 N MICHIGAN AVE",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402958",
            "telephone_number": "786-201-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEPLER",
        "first_name": "JENNY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.