Individual provider Active NPI

Nichole E Venzara

  • Family Nurse Practitioner
  • Merritt Island, FL
National Provider Identifier
1043875545
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11001702 Issued in FL
Practice address
255 Stewart Dr
Merritt Island, FL 32952-6414
Phone
(321) 302-6574
NPI assigned
May 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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 11001702 FL Primary

Addresses

Primary practice location

255 Stewart Dr
Merritt Island, FL 32952-6414

Mailing address

255 Stewart Dr
Merritt Island, FL 32952-6414
Phone (321) 302-6574

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL nichole.venzara@baycare.org Direct

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
I20191025000467 FL Practitioner - Nurse Practitioner 7012249980 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians

Practice addresses (Care Compare)

140 6TH Ave
Indialantic, FL 32903-3204
Phone (321) 312-3501

6470 US Hwy 1
Rockledge, FL 32955-5747
Phone (321) 425-2298

Hospital & facility affiliations

  • Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177
  • Viera Hospital Hospital, Melbourne, FL, CCN 100315

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11001702FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Florida, LLC CurrentSince Jan 1, 2025 Accepting new patients
Island Dermatology and Wellness Family CurrentSince Aug 30, 2023 Accepting new patients
Complete Care LLC CurrentSince Feb 1, 2023 Accepting new patients
Hobbs Pharmacy United Incorporated PastSince Feb 1, 2023 Accepting new patients

Locations

140 6th Ave
Indialantic, FL 32903
Phone (321) 312-3501

119 N Banana River Dr
Merritt Island, FL 32952
Phone (321) 452-0010

2400 N Courtenay Pkwy
Ste 100
Merritt Island, FL 32953
Phone (321) 784-8211

6470 US Highway 1
Rockledge, FL 32955
Phone (321) 425-2298

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958
Phone (727) 617-1777

Interoperability endpoints

  • Direct secure messaging: nichole.venzara.1@8042.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23154/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nvenzara@ccl-fl.direct.office.nextgen.com

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.

Hospital & facility affiliations 2

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": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1043875545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 STEWART DR",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329526414",
            "telephone_number": "321-302-6574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 STEWART DR",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329526414",
            "telephone_number": "321-302-6574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENZARA",
        "first_name": "NICHOLE",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-09",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11001702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "nichole.venzara@baycare.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "255 Stewart Dr",
            "city": "Merritt Island",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329526414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

Verify at the official NPI Registry.