Individual provider Active NPI

Emmanuelle Chassagne, NP

  • Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1841626470
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9211018 Issued in FL
Practice address
11948 Washington St
Pembroke Pines, FL 33025-5752
Phone
(954) 770-7059
NPI assigned
Sep 13, 2013
Last updated
Sep 13, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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 9211018 FL Primary

Addresses

Primary practice location

11948 Washington St
Pembroke Pines, FL 33025-5752

Mailing address

12656 SW 54TH St
Miramar, FL 33027-5478
Phone (954) 770-7059

Other names 1

  • Emmanuelle Chassagne- Gaston Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, NY, VA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20150507002612 FL Practitioner - Nurse Practitioner 5890014161 Reassigns benefits to 2 organizations
I20200215000201 GA Practitioner - Nurse Practitioner 5890014161 Reassigns benefits to 1 organization
I20251022001585 NY Practitioner - Nurse Practitioner 5890014161 Reassigns benefits to 1 organization
I20251118002015 VA Practitioner - Nurse Practitioner 5890014161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

424 Church St
Nashville, TN 37219-2301

800 SW 131St Ave
Apt F214
Pembroke Pines, FL 33027-6439

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9211018FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthypro LLC CurrentSince Jun 15, 2021 Accepting new patients
Lifegate Health & Wellness CurrentSince Jul 1, 2020 Accepting new patients
Community Care Health Network LLC Nurse Practitioner CurrentSince Oct 1, 2025 Accepting new patients
Matrix Medical of New York PC Nurse Practitioner CurrentSince Oct 1, 2025 Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Nov 1, 2025 Accepting new patients
Unlimited Vision LLC Past Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

2202 N West Shore Blvd
Tampa, FL 33607
Phone (813) 416-4680

2202 N West Shore Blvd
Ste 200
Tampa, FL 33607
Phone (317) 452-4352

1740 Broadway
Fl 15
New York, NY 10019
Phone (201) 256-5032

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

1806 Summit Ave
Richmond, VA 23230
Phone (213) 433-2823

Organizations & group practices 7

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": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1841626470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12656 SW 54TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330275478",
            "telephone_number": "954-770-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11948 WASHINGTON ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330255752",
            "telephone_number": "954-770-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASSAGNE",
        "first_name": "EMMANUELLE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9211018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMANUELLE",
            "last_name": "CHASSAGNE- GASTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.