Active NPI
Jacquelyn Marie Devito, NP
- Family Nurse Practitioner
- Brandon, FL
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(3) exclusion effective Mar 20, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 9427836
- Practice address
- 1104 N Parsons Ave Ste D
Brandon, FL 33510-3133 - Phone
- (727) 304-1515
- Fax
- (727) 471-5538
- NPI assigned
- Jun 12, 2013
- Last updated
- Jun 16, 2021
- 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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN9427836 | FL | |
| Nurse Practitioner | 363L00000X | C-APN.0001940-C-NP | DC | |
| Nurse Practitioner | 363L00000X | C-APN.0001940-C-NP | CO | |
| Nurse Practitioner | 363L00000X | NJDCATEMP-007508 | NJ | |
| Family Nurse Practitioner | 363LF0000X | 2292198 | MA | |
| Family Nurse Practitioner | 363LF0000X | 33338002 | NY | |
| Family Nurse Practitioner | 363LF0000X | 9427836 | FL | Primary |
Addresses
Primary practice location
1104 N Parsons Ave Ste D
Brandon, FL 33510-3133
Mailing address
8353 118TH Ave
Largo, FL 33773-5050
Phone (727) 304-1515
Other practice location 1
41 Mall Rd
Lahey Hospital and Medical Center
Burlington, MA 01805-0001
Phone (781) 744-8000
Other practice location 2
3116 Meta Ct
Largo, FL 33771-3951
Phone (727) 304-1515
Other practice location 3
9870 Lake Carillon Dr
Ste 300
St Petersburg, FL 33716
Phone (678) 321-8546
Other practice location 4
6600 30th Ave N
St Petersburg, FL 33710-3102
Phone (727) 381-4463
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 338002 | NY | MD | Internal Medicine Physician |
| C-APN.0001940-C-NP | CO | MD | Nurse Practitioner |
| C-APN.0001940-C-NP | DC | MD | Nurse Practitioner |
| APRN9427836 | FL | MD | Nurse Practitioner |
| 9427836 | FL | MD | Family Nurse Practitioner |
| 2292198 | MA | MD | Family Nurse Practitioner |
| 33338002 | NY | MD | Family Nurse Practitioner |
Interoperability endpoints
- jacquelyn.devito.p1@direct.alegiscare.nextgenshare.com
- jacquelyn.devito.p2@direct.alegiscare.nextgenshare.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Nurse Practitioner
- Brandon, FL
- NPI 1750942843
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623801600000",
"number": "1073951000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8353 118TH AVE",
"city": "LARGO",
"state": "FL",
"postal_code": "337735050",
"telephone_number": "727-304-1515",
"fax_number": "727-335-2254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1104 N PARSONS AVE STE D",
"city": "BRANDON",
"state": "FL",
"postal_code": "335103133",
"telephone_number": "727-304-1515",
"fax_number": "727-471-5538"
}
],
"practiceLocations": [
{
"address_1": "41 Mall Rd",
"address_2": "Lahey Hospital and Medical Center",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "MA",
"postal_code": "018050001",
"country_code": "US",
"telephone_number": "781-744-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3116 Meta Ct",
"address_purpose": "LOCATION",
"city": "Largo",
"state": "FL",
"postal_code": "337713951",
"country_code": "US",
"telephone_number": "727-304-1515",
"fax_number": "727-800-5543",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9870 LAKE CARILLON DR",
"address_2": "STE 300",
"address_purpose": "LOCATION",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "33716",
"country_code": "US",
"telephone_number": "678-321-8546",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6600 30th Ave N",
"address_purpose": "LOCATION",
"city": "St Petersburg",
"state": "FL",
"postal_code": "337103102",
"country_code": "US",
"telephone_number": "727-381-4463",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEVITO",
"first_name": "JACQUELYN",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-12",
"last_updated": "2021-06-16",
"certification_date": "2020-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "APRN9427836",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "DC",
"license": "C-APN.0001940-C-NP",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CO",
"license": "C-APN.0001940-C-NP",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NJ",
"license": "NJDCATEMP-007508",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "2292198",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "33338002",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "9427836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.