Individual provider Active NPI

Arielle Tango, FNP-C

  • Family Nurse Practitioner
  • Fort Pierce, FL
National Provider Identifier
1003584699
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11011884 Issued in FL
Practice address
2504 Acorn St Ste a
Fort Pierce, FL 34947-4746
Phone
(772) 837-7800
Fax
(772) 837-7801
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11011884 FL Primary

Addresses

Primary practice location

2504 Acorn St Ste a
Fort Pierce, FL 34947-4746

Mailing address

2504 Acorn St Ste a
Fort Pierce, FL 34947-4746
Phone (772) 837-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220316002459 FL Practitioner - Nurse Practitioner 4486049111
I20230506000203 TX Practitioner - Nurse Practitioner 4486049111 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maniilaq Association CurrentSince Jan 24, 2023 Accepting new patients
Grace Wellness Center LLC CurrentSince Mar 1, 2022 Accepting new patients
Maniilaq Association Current Accepting new patients
Maniilaq Association CurrentSince Jan 24, 2023 Accepting new patients

Locations

2504 Acorn St
Ste A
Fort Pierce, FL 34947
Phone (772) 466-1112

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1003584699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 ACORN ST STE A",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474746",
            "telephone_number": "772-837-7800",
            "fax_number": "772-837-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 ACORN ST STE A",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474746",
            "telephone_number": "772-837-7800",
            "fax_number": "772-837-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGO",
        "first_name": "ARIELLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11011884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.