Individual provider Active NPI

Jessica Sequeira, APRN

  • Family Nurse Practitioner
  • Wellington, FL
National Provider Identifier
1194327643
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11010117 Issued in FL
Practice address
1447 Medical Park Blvd Ste 208
Wellington, FL 33414-3183
Phone
(561) 753-7571
NPI assigned
Nov 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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 11010117 FL Primary

Addresses

Primary practice location

1447 Medical Park Blvd Ste 208
Wellington, FL 33414-3183

Mailing address

1447 Medical Park Blvd Ste 208
Wellington, FL 33414-3183
Phone (561) 753-7571

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
I20210614000630 FL Practitioner - Nurse Practitioner 5395145395 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11010117FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Small Hospital Innovations LLC CurrentSince Feb 7, 2023 Accepting new patients
Health Testing Solutions, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Elite Medical Services at Lakeside LLC CurrentSince Jun 1, 2021 Accepting new patients

Locations

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

241 SE 1st St
Belle Glade, FL 33430
Phone (561) 464-5500

39200 Hooker Hwy
Belle Glade, FL 33430
Phone (561) 992-9477

524 W Sagamore Ave
Clewiston, FL 33440
Phone (800) 494-3984

1500 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-4410

Interoperability endpoints

  • Direct secure messaging: jsequeira279422@mhsdirect.net

Organizations & group practices 3

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": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1194327643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 MEDICAL PARK BLVD STE 208",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143183",
            "telephone_number": "561-753-7571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 MEDICAL PARK BLVD STE 208",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143183",
            "telephone_number": "561-753-7571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEQUEIRA",
        "first_name": "JESSICA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11010117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.