Active NPI
Mary Claire McMillan, DO
- Family Medicine Physician
- Port St Lucie, FL
National Provider Identifier
1033812664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS23663
- Practice address
- 1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521 - Phone
- (772) 398-3623
- NPI assigned
- Mar 23, 2023
- Sex
- Female
- 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 Medicine Physician | 207Q00000X | OS23663 | FL | Primary |
Addresses
Primary practice location
1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521
Mailing address
1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521
Phone (772) 398-3623
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230706003864 | FL | Order and Referring Only - Family Practice | 5294194320 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2000 Health Park Dr
Brentwood, TN 37027-4692
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Interoperability endpoints
- mary.mcmillan@hca4.eclinicaldirectplus.com
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Port St Lucie, FL
- NPI 1538115696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781308800000",
"number": "1033812664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 SE TIFFANY AVE",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349527521",
"telephone_number": "772-398-3623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 SE TIFFANY AVE",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349527521",
"telephone_number": "772-398-3623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMILLAN",
"first_name": "MARY",
"middle_name": "CLAIRE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-23",
"last_updated": "2026-06-13",
"certification_date": "2026-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "OS23663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2026; 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.