Individual provider Active NPI

Grethchen L Abdulreda, ARNP

  • Family Health Clinical Nurse Specialist
  • Hollywood, FL
National Provider Identifier
1811335276
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X
License
ARNP9235551 Issued in FL
Practice address
1421 N 70TH Way
Hollywood, FL 33024-5442
Phone
(305) 798-7036
NPI assigned
Jun 7, 2013
Last updated
Jun 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X ARNP9235551 FL Primary

Addresses

Primary practice location

1421 N 70TH Way
Hollywood, FL 33024-5442

Mailing address

1421 N 70TH Way
Hollywood, FL 33024-5442
Phone (305) 798-7036

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
I20130924000371 FL Practitioner - Nurse Practitioner 3476797960 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, shared by 55 NPIs, 659 clinicians

Practice addresses (Care Compare)

1005 Joe Dimaggio Dr
Hollywood, FL 33021-5402
Phone (954) 265-7450

1150 N 35TH Ave
Suite 390
Hollywood, FL 33021-5429
Phone (954) 265-7450

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9235551FLMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Apr 11, 2017 Accepting new patients
South Broward Hospital District CurrentSince Apr 11, 2017 Accepting new patients
South Broward Hospital District CurrentSince Apr 14, 2019 Accepting new patients

Locations

1150 N 35th Ave
Ste 390
Hollywood, FL 33021
Phone (954) 265-7450

4651 Sheridan St
Ste 150
Pembroke Park, FL 33021
Phone (954) 265-6331

Interoperability endpoints

  • Direct secure messaging: gabdulreda162930@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1811335276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 N 70TH WAY",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330245442",
            "telephone_number": "305-798-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 N 70TH WAY",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330245442",
            "telephone_number": "305-798-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDULREDA",
        "first_name": "GRETHCHEN",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "FL",
            "license": "ARNP9235551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.