Individual provider Active NPI

Reginald Exilus, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Lauderdale Lakes, FL
National Provider Identifier
1801452628
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11002042 Issued in FL
Practice address
4700 N State Road 7
Lauderdale Lakes, FL 33319-5800
Phone
(954) 730-7284
NPI assigned
May 16, 2019
Last updated
Jul 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11002042 FL
Primary Care Nurse Practitioner 363LP2300X APRN11002042 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11002042 FL Primary

Addresses

Primary practice location

4700 N State Road 7
Lauderdale Lakes, FL 33319-5800

Mailing address

4740 N State Road 7
Lauderdale Lakes, FL 33319-5839
Phone (954) 486-4005

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
I20201118000490 FL Practitioner - Nurse Practitioner 8921419268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1531 NW 131St St
North Miami, FL 33167-1630

9863 NW 28TH St
Coral Springs, FL 33065-5041

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11002042FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Health Services LLC Family CurrentSince Apr 10, 2025 Accepting new patients
Henderson Behavioral Health, Inc. CurrentSince Nov 9, 2020 Accepting new patients
Henderson Behavioral Health, Inc. PastSince Nov 9, 2020 Accepting new patients

Locations

6100 Glades Rd
Ste 311
Boca Raton, FL 33434
Phone (561) 337-0210

330 SW 27th Ave
Ft Lauderdale, FL 33312
Phone (954) 463-0911

1957 Jackson St
Hollywood, FL 33020
Phone (954) 791-4300

4700 N State Road 7
Lauderdale Lakes, FL 33319
Phone (954) 730-7284

4740 N State Road 7
Ste 201
Lauderdale Lakes, FL 33319
Phone (954) 497-3850

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.

NPI Registry JSON

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1801452628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N STATE ROAD 7",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195839",
            "telephone_number": "954-486-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N STATE ROAD 7",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195800",
            "telephone_number": "954-730-7284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EXILUS",
        "first_name": "REGINALD",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-16",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11002042",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11002042",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11002042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

Verify at the official NPI Registry.