Individual provider Active NPI

Emily Mattingly, APRN

  • Nurse Practitioner
  • Palm Springs, FL
National Provider Identifier
1013315019
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9294072 Issued in FL
Practice address
1630 S Congress Ave Ste 200
Palm Springs, FL 33461-2171
Phone
(561) 253-3980
Fax
(561) 253-3985
NPI assigned
Dec 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9294072 FL Primary

Addresses

Primary practice location

1630 S Congress Ave Ste 200
Palm Springs, FL 33461-2171

Mailing address

1630 S Congress Ave Ste 200
Palm Springs, FL 33461-2171
Phone (561) 253-3980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150326001306 FL Practitioner - Nurse Practitioner 7911224142 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cancer Center of South Florida PLLCGroup PAC ID 8426120239, 47 clinicians

Practice addresses (Care Compare)

1630 S Congress Ave
Suite 200
Palm Springs, FL 33461-2171
Phone (561) 253-3980

Hospital & facility affiliations

  • Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253
  • HCA Florida JFK Hospital Hospital, Atlantis, FL, CCN 100080
  • Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168
  • Good Samaritan Medical Center Hospital, West Palm Beach, FL, CCN 100287
  • HCA Florida Palms West Hospital Hospital, Loxahatchee, FL, CCN 100269

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer Center of South Florida PLLC CurrentSince Dec 15, 2014 Accepting new patients
Jupiter Medical Center Physicians Group Inc CurrentSince Mar 4, 2017 Accepting new patients
Cancer Center of South Florida PLLC CurrentSince Dec 15, 2014 Accepting new patients
Jupiter Medical Center Physicians Group Inc CurrentSince Mar 4, 2017 Accepting new patients
Tampa General Hospital Current Accepting new patients

Locations

1002 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 741-5695

11621 Kew Gardens Ave
Ste 101A
Palm Beach Gardens, FL 33410
Phone (561) 832-1234

4801 S Congress Ave
Ste 201
Palm Springs, FL 33461
Phone (561) 649-8770

1630 S Congress Ave
Ste 200
Palm Springs, FL 33461
Phone (561) 621-0012

1309 N Flagler Dr
West Palm Beach, FL 33401
Phone (561) 650-6309

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: emattingly200617@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1013315019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 S CONGRESS AVE STE 200",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334612171",
            "telephone_number": "561-253-3980",
            "fax_number": "561-253-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 S CONGRESS AVE STE 200",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334612171",
            "telephone_number": "561-253-3980",
            "fax_number": "561-253-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "EMILY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-08",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9294072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, FL

Sources for this page

Verify at the official NPI Registry.