Individual provider Active NPI

Preetha Liju Kachappilly, ARNP

  • Family Nurse Practitioner
  • Cooper City, FL
National Provider Identifier
1750824447
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9269743 Issued in FL
Practice address
8395 SW 51St St
Cooper City, FL 33328-4339
Phone
(954) 504-0531
NPI assigned
Nov 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9269743 FL Primary

Addresses

Primary practice location

8395 SW 51St St
Cooper City, FL 33328-4339

Mailing address

8395 SW 51St St
Cooper City, FL 33328-4339
Phone (954) 504-0531

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240202003797 FL Practitioner - Nurse Practitioner 3577906890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

1740 Sheridan St
Hollywood, FL 33020-2275
Phone (954) 276-1565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9269743FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Jan 26, 2024 Accepting new patients
South Broward Hospital District CurrentSince Jan 26, 2024 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

16620 Sheridan St
Ft Lauderdale, FL 33331
Phone (954) 265-3451

8665 NW 186th St
Hialeah, FL 33015
Phone (305) 682-2626

1740 Sheridan St
Hollywood, FL 33020
Phone (954) 276-1565

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

Interoperability endpoints

  • Direct secure messaging: pkachappilly171514@mhsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1750824447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8395 SW 51ST ST",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333284339",
            "telephone_number": "954-504-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8395 SW 51ST ST",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333284339",
            "telephone_number": "954-504-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACHAPPILLY",
        "first_name": "PREETHA",
        "middle_name": "LIJU",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9269743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooper City, FL

Sources for this page

Verify at the official NPI Registry.