MY WELLNESS PRACTICE
NPI 1710734975
Family Medicine in Davie, FL

Active since May 03, 2024CLIA 10D2314560 · Waiver
12505 ORANGE DR STE 905, DAVIE, FL 33330(954) 839-6002(954) 539-6002 Get Directions Write a Review

NPPES record last updated: September 10, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 10, 2024, May 17, 2024, May 3, 2024 (3 updates tracked since 2024).

About My Wellness Practice NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MY WELLNESS PRACTICE (NPI 1710734975) is a healthcare organization registered as a family medicine in Davie, Florida and active in the NPI registry since May 2024. The organization holds a CLIA Waiver certificate valid through November 21, 2026 and lists Sumaira Jagvani, Owner, as its authorized official.

NPPES Registry Identity

NPI1710734975
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMY WELLNESS PRACTICE
Location Address12505 ORANGE DR STE 905Davie, FL 33330-4300
Mailing Address12505 Orange Dr Ste 905Davie, FL 33330-4300 · (954) 839-6002 · Fax (954) 539-6002
Fax(954) 539-6002
Organization SubpartNo
Authorized OfficialSumaira JagvaniOwner · (954) 439-4333
Enumeration DateMay 3, 2024
Last NPPES UpdateSeptember 10, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2024
✔ NPI 1710734975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
12505 ORANGE DR STE 905, Davie, FL 33330

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

My Wellness Practice is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to My Wellness Practice, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Nurse Practitioner
NPI 1740826692
2950 CLEVELAND CLINIC BLVD
Weston, FL 33331
(954) 659-5000
✔ PECOS✔ Accepts Medicare3.3 mi
Nurse Practitioner
NPI 1851000319
2950 CLEVELAND CLINIC BLVD
Weston, FL 33331
(954) 659-5000
✔ PECOS✔ Accepts Medicare3.3 mi
Family Practice
NPI 1205331824
4821 US HIGHWAY 19 STE 5
New Port Richey, FL 34652
(727) 532-0002
✔ PECOS✔ Accepts Medicare211 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2314560

My Wellness Practice · Davie, FL
Active · expires Nov 21, 2026
CLIA Number10D2314560
Laboratory TypePhysician Office
Certificate Effective DateNovember 22, 2024
Certificate Expiration DateNovember 21, 2026
Laboratory DirectorSumaira Jagvani
Laboratory Phone(954) 839-6002
Laboratory LocationMy Wellness Practice12555 Orange Drive Suite 100 A, Davie, FL 33330
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 My Wellness Practice's NPI number?

The NPI number for My Wellness Practice is 1710734975. It was assigned to this organization in the NPPES registry on May 3, 2024.

Where is My Wellness Practice located?

My Wellness Practice is located at 12505 Orange Dr Ste 905, Davie, FL 33330. The listed phone number is (954) 839-6002.

What is My Wellness Practice's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is My Wellness Practice enrolled in Medicare?

Yes. My Wellness Practice is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through My Wellness Practice?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to My Wellness Practice, in Family Practice and Nurse Practitioner. A 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 the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does My Wellness Practice hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2314560) is associated with this NPI, valid through November 21, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for My Wellness Practice was last updated on September 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.