Individual provider Active NPI

Jennifer Nicole Marshall, PA-C

  • Physician Assistant
  • Boca Raton, FL
National Provider Identifier
1891163283
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108906 Issued in FL
Practice address
9980 Central Park Blvd N
Suite 124
Boca Raton, FL 33428-1762
Phone
(561) 372-7546
NPI assigned
Sep 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAT9108906 FL
Physician Assistant 363A00000X PA9108906 FL Primary

Addresses

Primary practice location

9980 Central Park Blvd N
Suite 124
Boca Raton, FL 33428-1762

Mailing address

633 Heritage Dr
Weston, FL 33326-4547
Phone (954) 701-0034

Other names 1

  • Ms. Jennifer Nicole McLaughlin Former name

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
I20151118001252 FL Practitioner - Physician Assistant 6507166824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

1015 Crosspointe Dr
Naples, FL 34110-0949
Phone (239) 596-9075

121 S State Rd
Suite 7
Wellington, FL 33414-4338
Phone (561) 463-5923

200 Glades Rd
Suite 1
Boca Raton, FL 33432-1423
Phone (561) 395-7704

2031 Palm Beach Lakes Blvd
Suite 101
West Palm Beach, FL 33409-6501
Phone (561) 463-5933

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9108906FLMDPhysician Assistant
PAT9108906FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince Jan 1, 2022 Accepting new patients
Water'S Edge Dermatology, LLC CurrentSince Apr 1, 2018 Accepting new patients

Locations

200 Glades Rd
Ste 1
Boca Raton, FL 33432
Phone (561) 395-7704

9980 Central Park Blvd N
Ste 124
Boca Raton, FL 33428
Phone (561) 372-7546

5101 Okeechobee Rd
Fort Pierce, FL 34947
Phone (772) 595-5995

6250 Lantana Rd
Ste 9
Lake Worth, FL 33463
Phone (561) 578-8100

3659 S Miami Ave
Ste 6008
Miami, FL 33133
Phone (305) 854-5432

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

14840 Tamiami Trl
North Port, FL 34287
Phone (941) 564-1542

301 NE 19th Dr
Okeechobee, FL 34972
Phone (863) 357-0039

2845 Pga Blvd
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

600 Village Square Xing
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

264 NW Peacock Blvd
Ste 201
St Lucie West, FL 34986
Phone (772) 323-2321

121 S State Road 7
Wellington, FL 33414
Phone (561) 296-9666

2031 Palm Beach Lakes Blvd
Ste 101
West Palm Beach, FL 33409
Phone (561) 296-7710

2031 Palm Beach Lakes Blvd
#101
West Palm Beach, FL 33409
Phone (561) 296-7710

38162 Medical Center Ave
Zephyrhills, FL 33540
Phone (813) 782-2165

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jmarshall@aquadermatology.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1891163283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 HERITAGE DR",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333264547",
            "telephone_number": "954-701-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9980 CENTRAL PARK BLVD N",
            "address_2": "SUITE 124",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334281762",
            "telephone_number": "561-372-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9108906",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MCLAUGHLIN",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.