Individual provider Active NPI

Lori A Seegoolam, DNP

  • Adult Health Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1164620472
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2617522 Issued in FL
Practice address
1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521
Phone
(772) 335-4000
NPI assigned
Jul 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2617522 FL Primary

Addresses

Primary practice location

1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521

Mailing address

2876 NE Timberlane CT
Jensen Beach, FL 34957-4756

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 7723354000

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
I20080605000128 FL Practitioner - Nurse Practitioner 6103996954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of FL, LLCGroup PAC ID 9234596743, 513 clinicians

Practice addresses (Care Compare)

1800 SE Tiffany Ave
St. Lucie Medical Center
Port Saint Lucie, FL 34952-7521
Phone (772) 335-4000

340 NW Commerce Dr
Lake City Medical Center
Lake City, FL 32055-4709
Phone (850) 719-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2617522FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Martin Memorial Physician Corporation Inc Past Accepting new patients
Martin Memorial Medical Center Inc Past Accepting new patients
Associates of Pulmonary Medicine LLC PastSince Apr 5, 2020 Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1183852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1164620472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2876 NE TIMBERLANE CT",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349574756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SE TIFFANY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527521",
            "telephone_number": "772-335-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEEGOOLAM",
        "first_name": "LORI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-08",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "2617522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "7723354000",
            "affiliation": "N",
            "address_1": "1800 SE Tiffany Ave",
            "city": "Port St Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349527521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.