Individual provider Active NPI

Jacquelyn Marie Devito, NP

  • Family Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1073951000
Registry record updated Jun 16, 2021
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.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9427836 Issued in FL
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, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
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. Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
338002NYMDInternal Medicine Physician
C-APN.0001940-C-NPCOMDNurse Practitioner
C-APN.0001940-C-NPDCMDNurse Practitioner
APRN9427836FLMDNurse Practitioner
9427836FLMDFamily Nurse Practitioner
2292198MAMDFamily Nurse Practitioner
33338002NYMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: jacquelyn.devito.p1@direct.alegiscare.nextgenshare.com
  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.