Devoted Medical Group Professional Corporation - Medicare Primary Care in Pembroke Pines, FL

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Devoted Medical Group Professional Corporation is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Pembroke Pines, Florida. The current practice location for Devoted Medical Group Professional Corporation is 880 Sw 145th Ave Ste 202, Pembroke Pines, Florida. For appointments, you can reach them via phone at (866) 849-0692. The mailing address for Devoted Medical Group Professional Corporation is Po Box 211699, Eagan, Minnesota and phone number is () -.

Devoted Medical Group Professional Corporation is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1245838168. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (866) 849-0692.

Contact Information

Devoted Medical Group Professional Corporation
880 Sw 145th Ave Ste 202
Pembroke Pines
FL 33027-6171
(866) 849-0692
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameDevoted Medical Group Professional Corporation
SpecialityClinic/Center
Location880 Sw 145th Ave Ste 202, Pembroke Pines, Florida
Authorized Official Name and PositionNeil Wagle (CMO)
Authorized Official Contact6172566666
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Devoted Medical Group Professional Corporation
Po Box 211699
Eagan
MN 55121-3699

Ph: () -		Devoted Medical Group Professional Corporation
880 Sw 145th Ave Ste 202
Pembroke Pines
FL 33027-6171

Ph: (866) 849-0692

NPI Details:

NPI Number1245838168
Provider Enumeration Date10/13/2020
Last Update Date01/03/2025

Medicare PECOS Information:

Medicare PECOS PAC ID3072902816
Medicare Enrollment IDO20220726002167

Medical Identifiers

Medical identifiers for Devoted Medical Group Professional Corporation such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1245838168NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208D00000XGeneral Practice (* (Not Available))Secondary
261QP2300XClinic/center - Primary Care (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Devoted Medical Group Professional Corporation acts as a billing entity for following providers:
Provider NameAlice Yparraguirre
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912943374
PECOS PAC ID: 1850320979
Enrollment ID: I20050809000943
Provider NameCrystelle Carmack
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1295031169
PECOS PAC ID: 2668641044
Enrollment ID: I20120517000399
Provider NameChristina Szabo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710228309
PECOS PAC ID: 6103062922
Enrollment ID: I20130424000618
Provider NameDiane M Olea-del Rio
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104253210
PECOS PAC ID: 7517289705
Enrollment ID: I20141124002507
Provider NameStephanie Ten Eyck
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487043923
PECOS PAC ID: 3274853940
Enrollment ID: I20150520000843
Provider NameRachel Penning
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932632296
PECOS PAC ID: 0840576021
Enrollment ID: I20170425000913
Provider NameDiana Brady
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548798994
PECOS PAC ID: 9436428000
Enrollment ID: I20170713001574
Provider NameEva D Gonzalez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1063917706
PECOS PAC ID: 9436414398
Enrollment ID: I20180523001696
Provider NameBethany Reed
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285062836
PECOS PAC ID: 3779805288
Enrollment ID: I20180801003071
Provider NameCheyenna Lynne Kopacz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386204097
PECOS PAC ID: 2466788161
Enrollment ID: I20190801001013
Provider NameMegan Tyree
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356808265
PECOS PAC ID: 4183053382
Enrollment ID: I20200409002900
Provider NameJennifer Barney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245626472
PECOS PAC ID: 3072858893
Enrollment ID: I20200528001333
Provider NameKayla Pokrzywinski
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1063029700
PECOS PAC ID: 2466868013
Enrollment ID: I20210308000711
Provider NameTeresa Delbridge
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174164248
PECOS PAC ID: 1658706734
Enrollment ID: I20210917001915
Provider NameJulie Foster
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639565369
PECOS PAC ID: 0648586099
Enrollment ID: I20220830003992
Provider NameClaire Campbell
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1477842094
PECOS PAC ID: 0345462784
Enrollment ID: I20220912002054
Provider NameVanessa Pedroso
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235481722
PECOS PAC ID: 2961623343
Enrollment ID: I20220920000857
Provider NameJordan Seese
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154845931
PECOS PAC ID: 2264704519
Enrollment ID: I20220926003111
Provider NameLisa Byrd
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1407845829
PECOS PAC ID: 0042398133
Enrollment ID: I20221012001428
Provider NameMarlisa Trevino
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992113930
PECOS PAC ID: 1153541503
Enrollment ID: I20221019000894
Provider NameCindy Suthar
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750815981
PECOS PAC ID: 6204113194
Enrollment ID: I20230310001198
Provider NameNatalia Klusacek
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497142285
PECOS PAC ID: 1759686660
Enrollment ID: I20230310001988
Provider NamePaige Sparks
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982216594
PECOS PAC ID: 0749654424
Enrollment ID: I20230320002065
Provider NameAlyse Poll
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598135089
PECOS PAC ID: 8921309287
Enrollment ID: I20230329001059
Provider NameClaudia Fages
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730796426
PECOS PAC ID: 2769867381
Enrollment ID: I20230505001593
Provider NameJorge Nodal
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316583263
PECOS PAC ID: 0547695835
Enrollment ID: I20230706003558
Provider NameMiranda Caccamise
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831539436
PECOS PAC ID: 3476782095
Enrollment ID: I20230808003242
Provider NameJanet Brown
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730847591
PECOS PAC ID: 2567819279
Enrollment ID: I20231116002560
Provider NameAlyse Tumelson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386291912
PECOS PAC ID: 5799017679
Enrollment ID: I20240207003665
Provider NameAshley Maieritsch
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154865178
PECOS PAC ID: 5294019642
Enrollment ID: I20240212004406
Provider NameChristina Barr
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710480900
PECOS PAC ID: 7113280777
Enrollment ID: I20240403001769
Provider NameKendra Hurst
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780156844
PECOS PAC ID: 3870839491
Enrollment ID: I20240403001845
Provider NameValerie Valencia
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780181255
PECOS PAC ID: 0941556377
Enrollment ID: I20240403002495
Provider NameDevon Sharkey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942693387
PECOS PAC ID: 9436450533
Enrollment ID: I20240404000897
Provider NameRachel Weaver
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588084768
PECOS PAC ID: 5799157707
Enrollment ID: I20240411003961
Provider NameTrevor Cobb
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1427606763
PECOS PAC ID: 5991133571
Enrollment ID: I20240419002303
Provider NameReena Karimpanamannil Alex
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639575582
PECOS PAC ID: 5890019129
Enrollment ID: I20240419002875
Provider NameAlyssa Dukes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730752437
PECOS PAC ID: 1153710850
Enrollment ID: I20240419003144
Provider NameKelly Board
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649719915
PECOS PAC ID: 4789930645
Enrollment ID: I20240422001974
Provider NameKevin Mickle
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801360318
PECOS PAC ID: 1052651544
Enrollment ID: I20240422002851
Provider NameSalli Fulminar
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609275536
PECOS PAC ID: 7719356062
Enrollment ID: I20240423001991
Provider NameEllen Miftari
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962863498
PECOS PAC ID: 5698073054
Enrollment ID: I20240423002233
Provider NameKasey Kam
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013572338
PECOS PAC ID: 6002204757
Enrollment ID: I20240424000995
Provider NameTerri Thomas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679657266
PECOS PAC ID: 6800833542
Enrollment ID: I20240426002838
Provider NameShane Bridgman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447762380
PECOS PAC ID: 0749541902
Enrollment ID: I20240426003042
Provider NameRabia Chaudhry
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1598194409
PECOS PAC ID: 2163725409
Enrollment ID: I20240429002042
Provider NameSarah Bible
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699210351
PECOS PAC ID: 6800173832
Enrollment ID: I20240429002522
Provider NameAbigail Sladek
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205292653
PECOS PAC ID: 5294030599
Enrollment ID: I20240510000988
Provider NameMeghna Sheth
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942630603
PECOS PAC ID: 0446483101
Enrollment ID: I20240516002163
Provider NameAndrew Sumarsono
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1750822094
PECOS PAC ID: 3577980564
Enrollment ID: I20240516004239
Provider NameDaniel Horn
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1780903971
PECOS PAC ID: 8224277991
Enrollment ID: I20240521003442
Provider NameJeffrey Lin
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1326282716
PECOS PAC ID: 5193978369
Enrollment ID: I20240522000681
Provider NameRebecca Conroy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962959007
PECOS PAC ID: 2264712256
Enrollment ID: I20240528002162
Provider NameTamara Deshazo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326417171
PECOS PAC ID: 2769760776
Enrollment ID: I20240529001834
Provider NameJason Wong
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1821052242
PECOS PAC ID: 3375532559
Enrollment ID: I20240530002025
Provider NameMarilyn Canales
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083183347
PECOS PAC ID: 9537493861
Enrollment ID: I20240531002252
Provider NamePaul Di Capua
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1295037430
PECOS PAC ID: 5294990420
Enrollment ID: I20240531003316
Provider NameKellie Frissora
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245857762
PECOS PAC ID: 3577989722
Enrollment ID: I20240603003258
Provider NameNishea Flores
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831685635
PECOS PAC ID: 5698000461
Enrollment ID: I20240604001106
Provider NameMaria Mogollon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629676614
PECOS PAC ID: 6709299225
Enrollment ID: I20240604001964
Provider NameDeborah Evans
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1255572020
PECOS PAC ID: 5991858144
Enrollment ID: I20240606002711
Provider NameBrianna Kellett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053049403
PECOS PAC ID: 2466838511
Enrollment ID: I20240614003880
Provider NameBeth Vanairsdale
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932277514
PECOS PAC ID: 8022028257
Enrollment ID: I20240626001477
Provider NameSarah Marie Kirsch
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356818892
PECOS PAC ID: 4880931567
Enrollment ID: I20240711003014
Provider NameLourdes Ticas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1184715674
PECOS PAC ID: 7416021290
Enrollment ID: I20241016004045
Provider NameThomas Meridieth
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649855776
PECOS PAC ID: 5698178085
Enrollment ID: I20241029002418
Provider NameWimberly Cox
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154603611
PECOS PAC ID: 0244403566
Enrollment ID: I20241202001583
Provider NameJenny Barr
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629564380
PECOS PAC ID: 8022366202
Enrollment ID: I20250106001711

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.