Individual provider Active NPI

Marcia Jaffe

  • Specialist
  • Wellington, FL
National Provider Identifier
1902227895
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OT1100 Issued in FL
Practice address
13711 Doubletree TRL
Wellington, FL 33414-4020
Phone
(566) 312-4479
NPI assigned
Dec 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OT1100 FL Primary

Addresses

Primary practice location

13711 Doubletree TRL
Wellington, FL 33414-4020

Mailing address

13711 Doubletree TRL
Wellington, FL 33414-4020
Phone (561) 312-4479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT1100FLMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1902227895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13711 DOUBLETREE TRL",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144020",
            "telephone_number": "561-312-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13711 DOUBLETREE TRL",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144020",
            "telephone_number": "566-312-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFE",
        "first_name": "MARCIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-19",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "OT1100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.