NPIMap

Individual provider Active NPI

Jennifer Marilyn Logue, MD

  • Hematology (Internal Medicine) Physician
  • Pembroke Pines, FL
National Provider Identifier
1982090288
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
ME156141 Issued in FL
Practice address
603 N Flamingo Rd Ste 151
Pembroke Pines, FL 33028-1021
Phone
(954) 265-4325
NPI assigned
Apr 13, 2015
Last updated
Aug 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X ME156141 FL Primary

Addresses

Primary practice location

603 N Flamingo Rd Ste 151
Pembroke Pines, FL 33028-1021

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Other practice location 1

1750 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4611
Phone (954) 265-4325

Other identifiers 1

IdentifierTypeStateIssuer
114755300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220804003311 FL Practitioner - Hematology/Oncology 0749598548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Boston University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

1150 N 35 Ave
Hollywood, FL 33021-5424

12235 Pines Blvd
Pembroke Pines, FL 33026-4119
Phone (954) 265-4325

1750 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4611
Phone (954) 265-4325

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME156141FLMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Jul 1, 2022 Accepting new patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District Hematology CurrentSince Jul 1, 2022 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

20950 NE 27th Ct
Ste 203
Aventura, FL 33180
Phone (305) 933-6545

1750 E Hallandale Beach Blvd
Hallandale Beach, FL 33009
Phone (954) 276-9700

1150 N 35th Ave
Ste 170
Hollywood, FL 33021
Phone (954) 985-1500

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

603 N Flamingo Rd
Ste 151
Pembroke Pines, FL 33028
Phone (954) 265-2750

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 4

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": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1982090288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 N FLAMINGO RD STE 151",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281021",
            "telephone_number": "954-265-4325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 E Hallandale Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Hallandale Beach",
            "state": "FL",
            "postal_code": "330094611",
            "country_code": "US",
            "telephone_number": "954-265-4325",
            "fax_number": "954-276-0765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGUE",
        "first_name": "JENNIFER",
        "middle_name": "MARILYN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "FL",
            "license": "ME156141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114755300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.