Individual provider Active NPI

Yekaterina Ambrose, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lakewood Ranch, FL
National Provider Identifier
1063256097
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11033436 Issued in FL
Practice address
6600 University Pkwy Ste 304
Lakewood Ranch, FL 34240-9048
Phone
(833) 769-3524
NPI assigned
Jun 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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 APRN11033436 FL Primary

Addresses

Primary practice location

6600 University Pkwy Ste 304
Lakewood Ranch, FL 34240-9048

Mailing address

6600 University Pkwy Ste 304
Lakewood Ranch, FL 34240-9048
Phone (833) 769-3524

Other practice location 1

300 E Padonia Rd
Timonium, MD 21093-1002
Phone (301) 221-9073

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
I20240821000088 FL Practitioner - Nurse Practitioner 6608314703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

6600 University Pkwy
Suite 304
Lakewood Ranch, FL 34240-9048
Phone (941) 667-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Aug 23, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

2500 NW 107th Ave
Ste 102
Doral, FL 33172
Phone (786) 605-9400

14645 NW 77th Ave
Ste 101
Miami Lakes, FL 33014
Phone (786) 785-9033

6600 University Pkwy
Ste 304
Sarasota, FL 34240
Phone (941) 667-3600

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.yekaterinaambrose@141363.advancedmd-direct.com

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": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1063256097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 UNIVERSITY PKWY STE 304",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342409048",
            "telephone_number": "833-769-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 UNIVERSITY PKWY STE 304",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342409048",
            "telephone_number": "833-769-3524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 E Padonia Rd",
            "address_purpose": "LOCATION",
            "city": "Timonium",
            "state": "MD",
            "postal_code": "210931002",
            "country_code": "US",
            "telephone_number": "301-221-9073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "YEKATERINA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11033436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

Verify at the official NPI Registry.