Active NPI
Jency Nahomy Polanco, APRN
- Pediatrics Physician
- St Augustine, FL
National Provider Identifier
1700528056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- APRN11018207
- Practice address
- 3504 Kings Rd S
St Augustine, FL 32086-5079 - Phone
- (786) 295-9090
- NPI assigned
- Apr 8, 2022
- Last updated
- Apr 15, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | APRN11018207 | FL | Primary |
Addresses
Primary practice location
3504 Kings Rd S
St Augustine, FL 32086-5079
Mailing address
3504 Kings Rd S
St Augustine, FL 32086-5079
Phone (786) 295-9090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11018207 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saltzman, Tanis, Pittell, Levin and Jacobson, LLC | Pediatrics | Current | Accepting new patients |
| Angel Kids PA | Past | Accepting new patients | |
| East Pompano Pediatrics Corp | Pediatrics | Past | Accepting new patients |
Locations
601 E Sample Rd
Ste 107
Deerfield Beach, FL 33064
Phone (954) 210-7016
Interoperability endpoints
- https://api.platform.athenahealth.com/9792/brand/1/csg/1/fhir/r4
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.
-
dba Pediatric Associates
- Pediatrics Physician
- Pompano Beach, FL
- NPI 1740044858
-
- Primary Care Clinic/Center
- Jacksonville, FL
- NPI 1124162854
-
- Pediatrics Physician
- Pompano Beach, FL
- NPI 1871578641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776211200000",
"number": "1700528056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3504 KINGS RD S",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320865079",
"telephone_number": "786-295-9090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3504 KINGS RD S",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320865079",
"telephone_number": "786-295-9090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLANCO",
"first_name": "JENCY",
"middle_name": "NAHOMY",
"name_prefix": "Ms.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-08",
"last_updated": "2026-04-15",
"certification_date": "2026-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "APRN11018207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.