Individual provider Active NPI

Biju Antony, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Lauderdale Lakes, FL
National Provider Identifier
1912582008
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11013174 Issued in FL
Practice address
4850 W Oakland Park Blvd Ste 202
Lauderdale Lakes, FL 33313-7260
Phone
(305) 924-7726
NPI assigned
Mar 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F12200797 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11013174 FL Primary

Addresses

Primary practice location

4850 W Oakland Park Blvd Ste 202
Lauderdale Lakes, FL 33313-7260

Mailing address

12941 NW 2ND St Apt 204
Pembroke Pines, FL 33028-2233
Phone (305) 924-7726

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
I20220202002621 FL Practitioner - Nurse Practitioner 6002209699 Reassigns benefits to 2 organizations
Practice locations: Lauderdale Lakes, FL

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4850 W Oakland Park Blvd
Suite 202
Lauderdale Lakes, FL 33313-7260
Phone (305) 924-7726

Hospital & facility affiliations

  • Mother Maria Home Health Care Inc Home health agency, Hollywood, FL, CCN 687301
  • All Health Care Services Inc Home health agency, Greenacres, FL, CCN 109712

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F12200797FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nucleus Medical Inc Family CurrentSince Mar 18, 2025 Accepting new patients

Locations

4850 W Oakland Park Blvd
Ste 102
Lauderdale Lakes, FL 33313
Phone (954) 380-0714

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1912582008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12941 NW 2ND ST APT 204",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282233",
            "telephone_number": "305-924-7726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD STE 202",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137260",
            "telephone_number": "305-924-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONY",
        "first_name": "BIJU",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-10",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F12200797",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11013174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

Verify at the official NPI Registry.