Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Andy Deetjeen

Individual provider Physician Assistant · NPI 1053038976

Andy Deetjeen is a Physician Assistant in Lauderhill, Florida. Qualified in 2018, 8 years ago. Practices with Mulberry Medical LLC, a 30-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
8
In the registry since
2022
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Practice location Address checks out

2451 NW 41st Ave Apt 408
Lauderhill, FL 33313-3769
Phone: (646) 830-7804
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1053038976
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 21, 2022
Last updated in NPPESFebruary 3, 2023
Certification dateFebruary 3, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Mulberry Medical Llc — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

  • Angels Care Home Health Home health agency · Casa Grande, AZ

Colleagues at Mulberry Medical LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 30 clinicians in the practice; 12 are shown here.

Other providers in Lauderhill