Jimmy Dorival, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11019774 Issued in FL

Practice address

672 SW Prima Vista Blvd Ste 102
Port St Lucie, FL 34983-1820

Phone

(772) 905-2560

Fax

(772) 336-8341

NPI assigned

May 4, 2016

Last updated

Nov 17, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kopa LLCGroup PAC ID 5193774461, 40 clinicians

NP Health of FL LLCGroup PAC ID 2365867165, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdorival19677@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kopa LLC

  • Multi-Specialty Clinic/Center
  • Orlando, FL
  • NPI 1417021114
  Medicare reassignment Care Compare group NPD
• True Health Care PLLC

  • Family Nurse Practitioner
  • Miami, FL
  • NPI 1336011980
  Medicare reassignment NPD Authorized official
• NP Health of FL LLC

  • Physical Medicine & Rehabilitation Physician
  • Morton Grove, IL
  • NPI 1790393874

  FL

  Medicare reassignment Care Compare group NPD
• Tazkiyah Health Institute Inc

  dba Moyenda Medical Associates

  • Family Medicine Physician
  • Lake Worth, FL
  • NPI 1104313816
  Medicare reassignment NPD
• Vitae Health Medical Florida PLLC

  • Internal Medicine Physician
  • Rockledge, FL
  • NPI 1013562024
  Medicare reassignment NPD
• True Health Care LLC

  • Family Medicine Physician
  • Royal Palm Beach, FL
  • NPI 1356139679
  NPD Authorized official
• Your Health Klinik LLC

  • Family Medicine Physician
  • Royal Palm Beach, FL
  • NPI 1194541268
  NPD Authorized official
• Chiro Worx Injury Center Inc

  • Primary Care Clinic/Center
  • Plantation, FL
  • NPI 1801524459
  NPD

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1114372596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 MULBERRY GROVE RD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334114520",
            "telephone_number": "561-282-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 SW PRIMA VISTA BLVD STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349831820",
            "telephone_number": "772-905-2560",
            "fax_number": "772-336-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORIVAL",
        "first_name": "JIMMY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": "16-270",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11019774",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11019774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greg Dorcelia
• Esther Petit Phat Dorceus
• Teresa Diane Dore, L.M.H.C
• Golda Dorfeuille
• Doricare LLC
• Donald Dean Dorrington Jr.
• Sergelyn Dortely
• Andre Dorval, RN
• Christella Dorval
• Jessica Dorvil

• Family Nurse Practitioner in Port St Lucie, FL
• Providers in Port St 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 Nov 17, 2022; 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.