Individual provider Active NPI

Ryan Wilson Macalua, ARNP, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1174919377
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN9204952 Issued in FL
Practice address
9009 Corporate Lake Dr
Tampa, FL 33634-2367
Phone
(407) 274-8267
NPI assigned
Apr 14, 2015
Last updated
Dec 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9204952 FL
Family Nurse Practitioner 363LF0000X ARNP9204952 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN9204952 FL Primary

Addresses

Primary practice location

9009 Corporate Lake Dr
Tampa, FL 33634-2367

Mailing address

9009 Corporate Lake Dr
Tampa, FL 33634-2367

Other practice location 1

4700 Millenia Blvd Ste 500
Orlando, FL 32839-6019
Phone (813) 467-6111

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
I20170104001801 FL Practitioner - Nurse Practitioner 4880975911 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Behavioral Sciences- Orlando LLCGroup PAC ID 9739420654, 35 clinicians
Che Behavioral Health Services of Florida, P.a.Group PAC ID 5698185775, 31 clinicians

Practice addresses (Care Compare)

4700 Millenia Blvd
Suite 500
Orlando, FL 32839-6019
Phone (813) 277-4571

6750 N Andrews Ave
Suite 200
Ft Lauderdale, FL 33309-2180
Phone (888) 515-3834

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9204952FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Behavioral Sciences Orlando LLC CurrentSince Jul 7, 2025 Accepting new patients
Revitalizing Infusion Therapies, LLC Psychiatric/Mental Health CurrentSince Dec 5, 2024 Accepting new patients
Home Docs Family CurrentSince Sep 16, 2024 Accepting new patients
Primary Care of Oc LLC CurrentSince Sep 16, 2024 Accepting new patients
Primary Care of Orange City LLC Family CurrentSince Sep 16, 2024 Accepting new patients
Che Behavioral Health Services of Florida, P.a. Psychiatric/Mental Health CurrentSince Mar 1, 2021 Accepting new patients
Primary Care of Orange City LLC Nurse Practitioner CurrentSince Sep 16, 2024 Accepting new patients

Locations

100 E Dakin Ave
Kissimmee, FL 34741
Phone (321) 233-9282

6750 N Andrews Ave
Ste 200
Lauderdale Lakes, FL 33309
Phone (718) 408-5477

135 E Minnesota Ave
Orange City, FL 32763
Phone (386) 241-0274

4700 Millenia Blvd
Ste 500
Orlando, FL 32839
Phone (813) 277-4571

5510 N Hesperides St
Tampa, FL 33614
Phone (727) 418-2567

15820 Shaddock Dr
Ste 130
Winter Garden, FL 34787
Phone (407) 401-8855

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24896/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1174919377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9009 CORPORATE LAKE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336342367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9009 CORPORATE LAKE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336342367",
            "telephone_number": "407-274-8267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Millenia Blvd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328396019",
            "country_code": "US",
            "telephone_number": "813-467-6111",
            "fax_number": "813-467-6013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACALUA",
        "first_name": "RYAN",
        "middle_name": "WILSON",
        "name_prefix": "Mr.",
        "credential": "ARNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9204952",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9204952",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9204952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.