Individual provider Active NPI

Nathalie Dagobert, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Deerfield Beach, FL
National Provider Identifier
1033878574
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11016932 Issued in FL
Practice address
505 S Federal Hwy
Deerfield Beach, FL 33441-4109
Phone
(954) 793-1176
NPI assigned
Dec 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11016932 FL Primary

Addresses

Primary practice location

505 S Federal Hwy
Deerfield Beach, FL 33441-4109

Mailing address

7653 NW 79TH Ave Apt 208
Tamarac, FL 33321-2874
Phone (954) 793-1176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20260319003290 CA Practitioner - Nurse Practitioner 9335623172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12301 Wilshire Blvd
Suite 512
Los Angeles, CA 90025-1053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11016932FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mellow Medical Inc a Professional Corporation CurrentSince Feb 3, 2026 Accepting new patients

Locations

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (833) 427-3566

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

Interoperability endpoints

  • Direct secure messaging: nathalie.dagobert.1@9357.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1033878574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7653 NW 79TH AVE APT 208",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212874",
            "telephone_number": "954-793-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S FEDERAL HWY",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334414109",
            "telephone_number": "954-793-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGOBERT",
        "first_name": "NATHALIE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11016932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.