Active NPI
Jean B Pierre
- Physician Assistant
- Lake Worth, FL
National Provider Identifier
1629620034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 8416
- Practice address
- 5924 Ithaca Cir W
Lake Worth, FL 33463-1518 - Phone
- (561) 255-2227
- NPI assigned
- Jul 15, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 265-P.A | PR | |
| Physician Assistant | 363A00000X | 8416 | AZ | Primary |
Addresses
Primary practice location
5924 Ithaca Cir W
Lake Worth, FL 33463-1518
Mailing address
5924 Ithaca Cir W
Lake Worth, FL 33463-1518
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8416 | AZ | MD | General Practice Dentistry |
| 265-P.A | PR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675641600000",
"number": "1629620034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5924 ITHACA CIR W",
"city": "LAKE WORTH",
"state": "FL",
"postal_code": "334631518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5924 ITHACA CIR W",
"city": "LAKE WORTH",
"state": "FL",
"postal_code": "334631518",
"telephone_number": "561-255-2227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIERRE",
"first_name": "JEAN",
"middle_name": "B",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-15",
"last_updated": "2023-02-06",
"certification_date": "2023-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "265-P.A",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "8416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Worth, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.