KENYATTA DACRES
NPI 1356922850
Nurse Practitioner - Family in Jacksonville, FL
About Kenyatta Dacres NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENYATTA DACRES (NPI 1356922850) is an individual family provider in Jacksonville, Florida, licensed in Florida (11012249) and active in the NPI registry since April 2021. She is affiliated with Ascension St Vincent's Riverside and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kenyatta Dacres is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
4Medicare enrollment records show Kenyatta Dacres reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Jacksonville, FL 32216
- Reassigned Medicare billing, Florida enrollment
- 4 clinicians in this Medicare group
Jacksonville, FL 32224
- Reassigned Medicare billing, Florida enrollment
- 52 clinicians in this Medicare group
Pensacola, FL 32503
- Reassigned Medicare billing, Florida enrollment
- 34 clinicians in this Medicare group
Dallas, TX 75244
- Reassigned Medicare billing, Florida enrollment
- 168 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Ascension St Vincent's Riverside
Acute Care Hospitals · Jacksonville, FLAscension St Vincent's Southside
Acute Care Hospitals · Jacksonville, FLAscension St Vincent's St Johns County
Acute Care Hospitals · St Johns, FLPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 32210 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kenyatta Dacres's NPI number?
The NPI number for Kenyatta Dacres is 1356922850. It was assigned to this individual provider in the NPPES registry on April 16, 2021.
Where is Kenyatta Dacres located?
Kenyatta Dacres practices at 4510 Rainer Rd, Jacksonville, FL 32210. The listed phone number is (904) 535-1977.
What is Kenyatta Dacres's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kenyatta Dacres enrolled in Medicare?
Yes. Kenyatta Dacres is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kenyatta Dacres's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kenyatta Dacres reassigns Medicare benefits to 4 organizations: Florida Psychiatry And Wellness, PLLC (Jacksonville, FL), Florida Institute Of Pain Medicine LLC (Jacksonville, FL), Shc Medical Partners Of Florida, LLC (Pensacola, FL) and Signify Health Medical Associates, PLLC (Dallas, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenyatta Dacres's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kenyatta Dacres accept?
Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and UnitedHealthcare list Kenyatta Dacres as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Kenyatta Dacres affiliated with any hospitals?
According to CMS data, Kenyatta Dacres is affiliated with Ascension St Vincent's Riverside, Ascension St Vincent's Southside and Ascension St Vincent's St Johns County.
When was this NPI record last updated?
The NPPES record for Kenyatta Dacres was last updated on April 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kenyatta Dacres · NPI 1356922850
Family physician in Jacksonville, Florida. Individual provider, active in the CMS NPPES registry since April 16, 2021.
## Identity
- **NPI:** 1356922850 (Entity type: Individual)
- **Enumerated:** April 16, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 11012249 (Florida)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4510 RAINER RD, Jacksonville, FL 32210-7058
- **Phone:** (904) 535-1977
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Florida Psychiatry And Wellness, PLLC (NPI 1356200711, Jacksonville, FL); Florida Institute Of Pain Medicine LLC (NPI 1194056283, Jacksonville, FL); Shc Medical Partners Of Florida, LLC (NPI 1861677064, Pensacola, FL); Signify Health Medical Associates, PLLC (NPI 1750845863, Dallas, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** April 16, 2021
---
Source: [NPI Profile](https://npiprofile.com/npi/1356922850) · Data from the CMS NPPES public registry.