MISS TYESHA BOWEN (AGNP) – Adult Health Nurse Practitioner, NPI 1629440516

MISS TYESHA BOWEN (AGNP) is a healthcare provider. based in Pembroke pines, Florida. specializing in Adult Health Nurse Practitioner. They hold the professional credentials AGNP. They hold a License No. ARNP9358144 (FL). The NPI Number for MISS TYESHA BOWEN (AGNP) is 1629440516

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
MISS TYESHA BOWEN (AGNP)
NPI
1629440516
Phone
(954) 392-7157
Address
600 N HIATUS RD
Enumeration Date
30 October 2015
Last Update Date
3 April 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9543927157
Graduation Year
2015 (11 years ago)
PAC ID
7012255102
Group Practice PAC ID
4789919028
Professional Enrollment ID
I20190215000203
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:10State licenses:1Digital endpointsOther names

Provider Addresses for MISS TYESHA BOWEN (AGNP)

  • 600 N HIATUS RD

    PEMBROKE PINES, FL 330265207

    Phone: (954) 392-7157

    Type: Mailing

  • 276 KENSINGTON WAY

    ROYAL PALM BEACH, FL 334144316

    Phone: (561) 412-8992

    Fax: (401) 238-6057

    Type: Mailing

  • 1691 FORUM PL STE B

    WEST PALM BEACH, FL 334012336

    Phone: (561) 412-8992

    Fax: (401) 238-6057

    Type: Location

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: 2019-02-15

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
I20190215000203INurse 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 33026)

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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: 4789919028View full group profile
NameSpecialtyState
Nurse PractitionerFL

Reviews

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Frequently asked questions

What federal number belongs to MISS TYESHA BOWEN (AGNP)?
The federal identifier for MISS TYESHA BOWEN (AGNP) is NPI 1629440516.
Is MISS TYESHA BOWEN (AGNP) active in the national directory?
MISS TYESHA BOWEN (AGNP)'s public NPI profile is in an active state.
Does MISS TYESHA BOWEN (AGNP) list a primary specialty?
If you are matching referrals, note Adult Health Nurse Practitioner for MISS TYESHA BOWEN (AGNP). Clinical services aligned with this taxonomy classification.
Where is MISS TYESHA BOWEN (AGNP)'s primary listing?
We display Pembroke Pines, Florida because that is what the record indicates for MISS TYESHA BOWEN (AGNP).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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