NPIMap

Organization Active NPI

PMR la Holding, LLC

Doing business as Jencare Senior Medical Center

  • Specialist
  • Miami Gardens, FL
National Provider Identifier
1700333689
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PMR LA HOLDING, LLC
Doing business as
Jencare Senior Medical Center
Practice address
1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone
(305) 628-6117
NPI assigned
Sep 8, 2016
Last updated
Oct 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Mary Chen
Title
Authorized Official
Phone
(305) 831-4722

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY.007546-IR LA
Specialist 174400000X NU Primary
Non-Pharmacy Dispensing Site 332900000X NU

Addresses

Primary practice location

1395 NW 167TH St
Miami Gardens, FL 33169-5710

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5742
Phone (305) 831-4760

Other names 1

  • JENCARE SENIOR MEDICAL CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210416001427 LA Part B Supplier - Clinic/Group Practice 7315355062 Receives reassigned benefits from 35 practitioners
Practice locations: Gretna, LA; Kenner, LA; Metairie, LA; New Orleans, LA; Westwego, LA

National Provider Directory

National Provider Directory
Tax ID family
PMR la Holding LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3530 Houma Blvd
Ste 300
Metairie, LA 70006
Phone (504) 264-5142

4710 S Carrollton Ave
New Orleans, LA 70119
Phone (504) 454-9020

1070 Westbank Expy
Westwego, LA 70094
Phone (504) 688-2211

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1700333689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695742",
            "telephone_number": "305-831-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PMR LA HOLDING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-08",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "305-831-4722"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "LA",
            "license": "PHY.007546-IR",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JENCARE SENIOR MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.