MR. JORDAN J AUGUSTIN (APRN, PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1104336387
Psychiatric/Mental Health Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MR. JORDAN J AUGUSTIN (APRN, PMHNP-BC)
17385 NW 7TH AVE APT 101
MIAMI GARDENS, FL 331697090
Phone: (954) 461-3172
Type: Mailing
4200 SW 54TH CT
FORT LAUDERDALE, FL 333146726
Phone: (754) 312-5500
Type: Location
2500 N Federal Hwy Ste 103
Fort Lauderdale, FL 333051618
Phone: (954) 280-4025
Type: Location
4121 NW 5th St
Plantation, FL 333172250
Phone: (954) 797-5222
Type: Location
83 Hanover Rd
Florham Park, NJ 079321508
Phone: (908) 460-8909
Type: Location
5100 N FEDERAL HWY STE 100
FORT LAUDERDALE, FL 333083842
Phone: (754) 777-6304
Type: Location
15385 SW 51ST ST
DAVIE, FL 333312844
Phone: (954) 461-3172
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $210.
Total Amount is formed as General ($210) + Research ($0) + Ownership ($0) = $210.
Last reported payment date: 2024-08-08 • Largest payer in this snapshot: ViiV Healthcare Company ($125).
Total Amount
$210
General + Research + Ownership
Payments
5
Total payment records
General Amount
$210
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ViiV Healthcare Company | $125 |
| Indivior Inc. | $30 |
| Alkermes, Inc. | $25 |
| ITI, Inc. | $16 |
| Braeburn Inc. | $14 |
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: 2018-06-12
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180612000268 | I | Nurse Practitioner | FL | TBD |
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.
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 33169)
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