Active NPI
Jacqueline Rendon, PA
- Physician Assistant
- Cutler Bay, FL
National Provider Identifier
1881280964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9113800
- Practice address
- 10300 SW 216TH St
Cutler Bay, FL 33190-1003 - Phone
- (305) 253-5100
- NPI assigned
- Dec 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9113800 | FL | Primary |
Addresses
Primary practice location
10300 SW 216TH St
Cutler Bay, FL 33190-1003
Mailing address
10300 SW 216TH St
Cutler Bay, FL 33190-1003
Phone (305) 251-5100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113273500 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health of South Florida, Inc. | Current | Accepting new patients | |
| Community Health of South Florida, Inc | Current | Accepting new patients |
Locations
10300 SW 216th St
Cutler Bay, FL 33190
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Miami, FL
- NPI 1336152347
-
- Specialist
- Hallandale, FL
- NPI 1669500328
-
- Obstetrics & Gynecology Physician
- Miami, FL
- NPI 1871572032
-
- Federally Qualified Health Center (FQHC)
- Key Largo, FL
- NPI 1417704198
-
- Federally Qualified Health Center (FQHC)
- Naranja, FL
- NPI 1023271855
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676937600000",
"number": "1881280964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10300 SW 216TH ST",
"city": "CUTLER BAY",
"state": "FL",
"postal_code": "331901003",
"telephone_number": "305-251-5100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10300 SW 216TH ST",
"city": "CUTLER BAY",
"state": "FL",
"postal_code": "331901003",
"telephone_number": "305-253-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENDON",
"first_name": "JACQUELINE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-14",
"last_updated": "2023-02-21",
"certification_date": "2023-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9113800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "113273500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cutler Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.