Jeanette D. Campos Pham, ARNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

ARNP2748312 Issued in FL

Practice address

1815 Griffin Rd Ste 204
Dania Beach, FL 33004-2252

Phone

(954) 624-7900

Fax

(877) 283-0663

NPI assigned

Jun 12, 2012

Last updated

Dec 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seasons Medical Group of Florida PAGroup PAC ID 0941451314, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

Merit-based Incentive Payment System (MIPS)

Final score

82.26 of 100Reported as group

Quality

60.1

Improvement activities

40

Cost

80.67

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Seasons Medical Group of Florida PA

  dba AccentCare Medical Group of Florida

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1710238381
  Medicare reassignment Care Compare group NPD
• Dennis K King MD PA

  • Pulmonary Disease Physician
  • Melbourne, FL
  • NPI 1427114677
  NPD (past)
• Seasons Hospice & Palliative Care of Broward Florida LLC

  dba AccentCare Hospice & Palliative Care of Broward County

  • Community Based Hospice Care Agency
  • Plantation, FL
  • NPI 1467851840
  NPD (past)
• Coffee County Board of Health

  dba Coffee Wellness Center

  • Public Health or Welfare Agency
  • Douglas, GA
  • NPI 1316976699
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Broward Hospital District

  dba Memorial Regional Hospital

  • General Acute Care Hospital
  • Hollywood, FL
  • NPI 1780667923
  Care Compare affiliation

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1700148111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SHAFER CT STE 700",
            "city": "ROSEMONT",
            "state": "IL",
            "postal_code": "600184989",
            "telephone_number": "847-692-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 GRIFFIN RD STE 204",
            "city": "DANIA BEACH",
            "state": "FL",
            "postal_code": "330042252",
            "telephone_number": "954-624-7900",
            "fax_number": "877-283-0663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JEANETTE",
        "middle_name": "D. CAMPOS",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP2748312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniela Padron Garcia
• George Parente, PHYSICAL THERAPY
• Michelle Joanne Parente, P.T.
• Alexis Jenna Pena, MD
• Richard Idiel Perez, RBT
• Alyssa Hillman Pinnock, D.M.D.
• Shoshanna Ellen Poznanski, RBT
• Premium Mobility LLC
• Diana Marie Price, OT, CHT
• Publix Super Markets Inc (Publix Pharmacy #0788)

• Adult Health Nurse Practitioner in Dania Beach, FL
• Providers in Dania Beach, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.