Individual provider Active NPI

Evelina Ingersoll, ARNP

  • Family Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1124698527
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11013917 Issued in FL
Practice address
1400 SE Goldtree Dr Ste 107
Port St Lucie, FL 34952-7582
Phone
(772) 335-3550
Fax
(772) 337-4113
NPI assigned
Jun 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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 APRN11013917 FL Primary

Addresses

Primary practice location

1400 SE Goldtree Dr Ste 107
Port St Lucie, FL 34952-7582

Mailing address

900 Village Square Xing Ste 290
Palm Beach Gardens, FL 33410-4552
Phone (561) 693-0540

Other practice location 1

5101 Okeechobee Rd
Fort Pierce, FL 34947-5415
Phone (772) 595-5995

Other practice location 2

2601 S Kanner Hwy
Stuart, FL 34994-4622
Phone (772) 219-2777

Other practice location 3

264 NW Peacock Blvd Ste 202
Port St Lucie, FL 34986-2272
Phone (772) 871-1682

Other practice location 4

2031 Palm Beach Lakes Blvd # 101
West Palm Beach, FL 33409-6501
Phone (561) 296-7710

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
I20210715000932 FL Practitioner - Nurse Practitioner 1759783665 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

261 9TH St S
Naples, FL 34102-6258
Phone (239) 216-4337

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aqua Dermatology of Florida, PA CurrentSince Jan 1, 2022 Accepting new patients
Water'S Edge Dermatology, LLC CurrentSince Aug 1, 2021 Accepting new patients
Water'S Edge Dermatology, LLC CurrentSince Aug 1, 2021 Accepting new patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince Jan 1, 2022 Accepting new patients

Locations

5101 Okeechobee Rd
Fort Pierce, FL 34947
Phone (772) 595-5995

6250 Lantana Rd
Ste 9
Lake Worth, FL 33463
Phone (561) 578-8100

3659 S Miami Ave
Ste 6008
Miami, FL 33133
Phone (305) 854-5432

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

261 9th St S
Naples, FL 34102
Phone (239) 216-4337

14840 Tamiami Trl
North Port, FL 34287
Phone (941) 564-1542

301 NE 19th Dr
Okeechobee, FL 34972
Phone (863) 357-0039

2845 Pga Blvd
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

1400 SE Goldtree Dr
Ste 107
Port St Lucie, FL 34952
Phone (772) 217-6551

264 NW Peacock Blvd
Ste 202
Port St Lucie, FL 34986
Phone (772) 871-1682

264 NW Peacock Blvd
St Lucie West, FL 34986
Phone (772) 208-8800

264 NW Peacock Blvd
Ste 201
St Lucie West, FL 34986
Phone (772) 323-2321

2601 S Kanner Hwy
Stuart, FL 34994
Phone (772) 217-6829

900 Village Square Xing
Ste 290
West Palm Beach, FL 33410
Phone (239) 313-2517

3400 Forest Hill Blvd
West Palm Beach, FL 33406
Phone (561) 357-5636

2031 Palm Beach Lakes Blvd
#101
West Palm Beach, FL 33409
Phone (561) 296-7710

2031 Palm Beach Lakes Blvd
Ste 101
West Palm Beach, FL 33409
Phone (561) 296-7710

38162 Medical Center Ave
Zephyrhills, FL 33540
Phone (813) 782-2165

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: eingersoll@aquadermatology.emadirect.md

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": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1124698527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 VILLAGE SQUARE XING STE 290",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104552",
            "telephone_number": "561-693-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SE GOLDTREE DR STE 107",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527582",
            "telephone_number": "772-335-3550",
            "fax_number": "772-337-4113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5101 Okeechobee Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349475415",
            "country_code": "US",
            "telephone_number": "772-595-5995",
            "fax_number": "772-595-5990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 S Kanner Hwy",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349944622",
            "country_code": "US",
            "telephone_number": "772-219-2777",
            "fax_number": "772-219-0017",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "264 NW Peacock Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349862272",
            "country_code": "US",
            "telephone_number": "772-871-1682",
            "fax_number": "772-323-2523",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2031 Palm Beach Lakes Blvd # 101",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334096501",
            "country_code": "US",
            "telephone_number": "561-296-7710",
            "fax_number": "561-296-7709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGERSOLL",
        "first_name": "EVELINA",
        "name_prefix": "Miss",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11013917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.