Individual provider Active NPI

Abigail Rebecca Lee, ARNP

  • Pediatric Nurse Practitioner
  • Coconut Creek, FL
National Provider Identifier
1730323718
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
9266851 Issued in FL
Practice address
4570 Lyons Rd
Suite 110
Coconut Creek, FL 33073-3481
Phone
(954) 971-3210
Fax
(954) 971-3427
NPI assigned
Apr 22, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 9266851 FL Primary

Addresses

Primary practice location

4570 Lyons Rd
Suite 110
Coconut Creek, FL 33073-3481

Mailing address

900 S Pine Island Rd
Suite 800
Plantation, FL 33324-3920
Phone (954) 971-3210

Other identifiers 1

IdentifierTypeStateIssuer
003828500MedicaidFL

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

LicenseStateTypeSpecialty
9266851FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saltzman, Tanis, Pittell, Levin and Jacobson Past Accepting new patients
Saltzman, Tanis, Pittel, Levin and Jacobson Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alee@pa.trimed.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1730323718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD",
            "address_2": "SUITE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243920",
            "telephone_number": "954-971-3210",
            "fax_number": "954-971-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 LYONS RD",
            "address_2": "SUITE 110",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733481",
            "telephone_number": "954-971-3210",
            "fax_number": "954-971-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ABIGAIL",
        "middle_name": "REBECCA",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-22",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "9266851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003828500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.