Individual provider Active NPI

Nevenka Metikos, NURSE PRACTITIONER

  • Nurse Practitioner
  • Boca Raton, FL
National Provider Identifier
1790923134
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP 9205027 Issued in FL
Practice address
5700 NW 2ND Ave
#611
Boca Raton, FL 33487-4803
Phone
(561) 703-3071
NPI assigned
Jan 22, 2009
Last updated
Jan 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP 9205027 FL Primary

Addresses

Primary practice location

5700 NW 2ND Ave
#611
Boca Raton, FL 33487-4803

Mailing address

5700 NW 2ND Ave
#611
Boca Raton, FL 33487-4803

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
I20090313000515 FL Practitioner - Nurse Practitioner 0042377244 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 9205027FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatrics of Boca Delray PA CurrentSince Nov 1, 2016 Accepting new patients
Legacy Physiatry Group LLC CurrentSince Mar 1, 2018 Accepting new patients

Locations

5493 Wiles Rd
Ste 106
Coconut Creek, FL 33073
Phone (321) 214-4530

16244 S Military Trl
Ste 470
Delray Beach, FL 33484
Phone (561) 495-9289

850 Central Pkwy E
Ste 275
Plano, TX 75074

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1790923134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 NW 2ND AVE",
            "address_2": "#611",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334874803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 NW 2ND AVE",
            "address_2": "#611",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334874803",
            "telephone_number": "561-703-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METIKOS",
        "first_name": "NEVENKA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-22",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 9205027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.