Individual provider Active NPI

Pamela A Homer, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Rockledge, FL
National Provider Identifier
1124162995
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0995760 Issued in CO
Practice address
1770 Cedar St
Rockledge, FL 32955-3133
Phone
(321) 890-1500
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Registered Nurse 163W00000X 99914 CO
Psychiatric/Mental Health Registered Nurse 163WP0808X 0995760 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0995760 CO Primary

Addresses

Primary practice location

1770 Cedar St
Rockledge, FL 32955-3133

Mailing address

400 E Sheridan Rd
Melbourne, FL 32901-3184
Phone (321) 722-5273

Other names 1

  • Pamela A Oseles-Mast Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200903000515 CO Practitioner - Nurse Practitioner 1052738184 Reassigns benefits to 2 organizations
I20220711003001 FL Practitioner - Nurse Practitioner 1052738184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clarity Mental Health, PLLCGroup PAC ID 7416202999, 5 clinicians

Practice addresses (Care Compare)

753 Maleta LN
Suite 204
Castle Rock, CO 80108-7609
Phone (303) 993-6071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
99914COMDRegistered Nurse
0995760COMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diana Smith Psychiatric Mental Health Nurse Practitioner LLC CurrentSince Nov 11, 2024 Accepting new patients
Clarity Mental Health, PLLC Psychiatric/Mental Health CurrentSince Aug 30, 2020 Accepting new patients
Circles of Care, Inc. CurrentSince Jul 14, 2022 Accepting new patients
Circles of Care, Inc. Mental Health CurrentSince Jul 14, 2022 Accepting new patients

Locations

753 Maleta Ln
Ste 203
Castle Rock, CO 80108
Phone (303) 993-6071

753 Maleta Ln
Ste 204
Castle Rock, CO 80108
Phone (303) 993-6071

635 W Corona Ave
Ste 205
Pueblo, CO 81004
Phone (719) 289-6002

400 Sheridan Rd
Melbourne, FL 32901
Phone (321) 722-5273

1770 Cedar St
Rockledge, FL 32955
Phone (321) 634-6257

Organizations & group practices 4

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1124162995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E SHERIDAN RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013184",
            "telephone_number": "321-722-5273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 CEDAR ST",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553133",
            "telephone_number": "321-890-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMER",
        "first_name": "PAMELA",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "99914",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0995760",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0995760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "OSELES-MAST",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rockledge, FL

Sources for this page

Verify at the official NPI Registry.