JAELYN BROWN – Nurse Practitioner, NPI 1609615830

JAELYN BROWN is a healthcare provider. based in Tampa, Florida. specializing in NURSE PRACTITIONER. They hold a License No. 11031046 (FL). The NPI Number for JAELYN BROWN is 1609615830

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
JAELYN BROWN
NPI
1609615830
Phone
(813) 384-8872
Address
4129 W KENNEDY BLVD STE 2
Enumeration Date
20 May 2024
Last Update Date
20 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8135411466
Graduation Year
2023 (3 years ago)
PAC ID
9133669542
Group Practice PAC ID
6305169160
Professional Enrollment ID
I20240912001474
Address ID
FL336092254TA4129XBLVD402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:2State licenses:1Digital endpointsOther names

24,243 NURSE PRACTITIONER in FL

Provider Addresses for JAELYN BROWN

  • 4129 W KENNEDY BLVD STE 2

    TAMPA, FL 336092254

    Phone: (813) 384-8872

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-09-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240912001474INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33609)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305169160View full group profile
NameSpecialtyState
Nurse PractitionerFL
Infectious Disease, Internal MedicineFL

Reviews

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Frequently asked questions

How do I look up JAELYN BROWN by NPI?
Use NPI 1609615830 when you need to reference JAELYN BROWN in forms, claims, or directories.
Is JAELYN BROWN active in the national directory?
JAELYN BROWN's public NPI profile is in an active state.
Does JAELYN BROWN list a primary specialty?
If you are matching referrals, note Nurse Practitioner for JAELYN BROWN. Clinical services aligned with this taxonomy classification.
Where is JAELYN BROWN's primary listing?
We display Tampa, Florida because that is what the record indicates for JAELYN BROWN.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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