Individual provider Active NPI

Bryan Hennes, ARNP

  • Adult Health Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1861654758
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
9175755 Issued in FL
Practice address
1601 N Palm Ave
Suite 109
Pembroke Pines, FL 33026-3200
Phone
(954) 432-1511
Fax
(954) 432-5195
NPI assigned
Jul 1, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 9175755 FL Primary

Addresses

Primary practice location

1601 N Palm Ave
Suite 109
Pembroke Pines, FL 33026-3200

Mailing address

1601 N Palm Ave
Suite 109
Pembroke Pines, FL 33026-3200
Phone (954) 432-1511

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
I20100312000696 FL Practitioner - Nurse Practitioner 4082749288 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Florida Trauma Network, LLCGroup PAC ID 7911175658, 14 clinicians

Practice addresses (Care Compare)

2010 59TH St W
Suite 2200
Bradenton, FL 34209-4689
Phone (941) 794-5621

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.62 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
76.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9175755FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Florida Trauma Network, LLC CurrentSince Aug 15, 2018 Accepting new patients
SMH Physician Services Inc CurrentSince Nov 18, 2024 Accepting new patients
West Florida Cardiology Network, LLC Past Accepting new patients

Locations

2010 59th St W
Ste 1600
Bradenton, FL 34209
Phone (941) 794-5621

2010 59th St W
Bradenton, FL 34209
Phone (813) 453-0590

2010 59th St W
Ste 1700
Bradenton, FL 34209
Phone (941) 752-2789

2010 59th St W
Ste 2200
Bradenton, FL 34209
Phone (941) 794-5621

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4692/brand/27/csg/1/fhir/r4

Organizations & group practices 4

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": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1861654758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N PALM AVE",
            "address_2": "SUITE 109",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263200",
            "telephone_number": "954-432-1511",
            "fax_number": "954-432-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N PALM AVE",
            "address_2": "SUITE 109",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263200",
            "telephone_number": "954-432-1511",
            "fax_number": "954-432-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNES",
        "first_name": "BRYAN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9175755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.