Active NPI
Brian Christopher Orcullo, APRN
- Family Nurse Practitioner
- Jacksonville, FL
National Provider Identifier
1013639160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN11021315
- Practice address
- 4796 Hodges Blvd Ste 101
Jacksonville, FL 32224-2209 - Phone
- (904) 449-7246
- NPI assigned
- Sep 15, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11021315 | FL | Primary |
Addresses
Primary practice location
4796 Hodges Blvd Ste 101
Jacksonville, FL 32224-2209
Mailing address
139 Boylston CT
Saint Augustine, FL 32092-0108
Phone (904) 859-7891
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4796 Hodges Blvd
Suite 101
Jacksonville, FL 32224-2209
Phone (904) 449-7246
Hospital & facility affiliations
- Baptist Health Medical Center - Jacksonville
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11021315 | FL | MD | Family Nurse Practitioner |
Organizations & group practices 1
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.
-
- Interventional Pain Medicine Physician
- Jacksonville, FL
- NPI 1194056283
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1578620449
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672531200000",
"number": "1013639160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 BOYLSTON CT",
"city": "SAINT AUGUSTINE",
"state": "FL",
"postal_code": "320920108",
"telephone_number": "904-859-7891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4796 HODGES BLVD STE 101",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322242209",
"telephone_number": "904-449-7246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORCULLO",
"first_name": "BRIAN",
"middle_name": "CHRISTOPHER",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-15",
"last_updated": "2023-01-01",
"certification_date": "2022-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11021315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.