Individual provider Active NPI

Kendall Wyckoff, APRN

  • Family Nurse Practitioner
  • Vero Beach, FL
National Provider Identifier
1235809120
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11015643 Issued in FL
Practice address
1000 36TH St
Vero Beach, FL 32960-4862
Phone
(772) 567-4311
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 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 11015643 FL Primary

Addresses

Primary practice location

1000 36TH St
Vero Beach, FL 32960-4862

Mailing address

426 Holly Rd
Vero Beach, FL 32963-1457
Phone (772) 539-2048

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
I20211006000682 FL Practitioner - Nurse Practitioner 4981002912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Indian River Health Services IncGroup PAC ID 9234130329, 335 clinicians

Practice addresses (Care Compare)

3450 11TH CT
Vero Beach, FL 32960-5012
Phone (772) 794-9771

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11015643FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Health Services Inc CurrentSince Nov 7, 2021 Accepting new patients
Indian River Health Services Inc CurrentSince Nov 7, 2021 Accepting new patients

Locations

3450 11th Ct
Ste 303
Vero Beach, FL 32960
Phone (772) 794-9771

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

1000 36th St
Vero Beach, FL 32960
Phone (772) 567-1942

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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 2

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": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1235809120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 HOLLY RD",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329631457",
            "telephone_number": "772-539-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 36TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604862",
            "telephone_number": "772-567-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYCKOFF",
        "first_name": "KENDALL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11015643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.