Jackeline Conde, APRN-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11010147 Issued in FL

Practice address

808 SW Glenview CT, Suites 812 and 814
Port Saint Lucie, FL 34953-3495

Phone

(772) 240-7822

NPI assigned

Dec 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cardiology Partners PLGroup PAC ID 5890751929, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: jconde19568@jupitermedicalcenter.direct-ci.com

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.

• Cardiology Partners PL

  • Cardiovascular Disease Physician
  • Wellington, FL
  • NPI 1518978626
  Medicare reassignment Care Compare group NPD
• P&O Pediatric and Fetal Cardiology and Wellness LLC

  • Pediatric Cardiology Physician
  • Port St Lucie, FL
  • NPI 1528898905
  NPD

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

• Jupiter Medical Center, Inc.

  • General Acute Care Hospital
  • Jupiter, FL
  • NPI 1295721090
  Care Compare affiliation

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1063018133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 SW IMPORT DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872051",
            "telephone_number": "305-216-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 SW GLENVIEW CT, SUITES 812 AND 814",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349533495",
            "telephone_number": "772-240-7822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 SW Import Dr",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "349872051",
            "country_code": "US",
            "telephone_number": "305-216-1619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONDE",
        "first_name": "JACKELINE",
        "name_prefix": "Mrs.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11010147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Concierge Community Care LLC
• Alejandro Condis Reyes, PTA
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• Jacob Connelly
• Sheila Marie Connolly, LMHC
• Charmin Howard Connor, MSW

• Family Nurse Practitioner in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.

Verify at the official NPI Registry.