Individual provider Active NPI

Kristin Hedden Grunbaum, A.R.N.P.

  • Family Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1114110228
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9212289 Issued in FL
Practice address
537 NW Lake Whitney Place Suite 103
Port St Lucie, FL 34986-1620
Phone
(772) 785-5864
Fax
(772) 344-2555
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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 ARNP9212289 FL Primary

Addresses

Primary practice location

537 NW Lake Whitney Place Suite 103
Port St Lucie, FL 34986-1620

Mailing address

537 NW Lake Whitney Place Suite 103
Port St Lucie, FL 34986-1620
Phone (772) 785-5864

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
I20080324000465 FL Practitioner - Nurse Practitioner 0547346157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Mark J Pamer DO LLCGroup PAC ID 2062558612, 3 clinicians

Practice addresses (Care Compare)

537 NW Lake Whitney PL
Suite 103
Port St Lucie, FL 34986-1620
Phone (772) 785-5864

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9212289FLMDFamily Nurse Practitioner

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FADICA/Endpoint/FADICA

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": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1114110228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 NW LAKE WHITNEY PLACE SUITE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861620",
            "telephone_number": "772-785-5864",
            "fax_number": "772-344-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 NW LAKE WHITNEY PLACE SUITE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861620",
            "telephone_number": "772-785-5864",
            "fax_number": "772-344-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNBAUM",
        "first_name": "KRISTIN",
        "middle_name": "HEDDEN",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9212289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.