Individual provider Active NPI

Tiffany M Pereau, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1255063509
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11019343 Issued in FL
Practice address
2 Shircliff Way Ste 600
Jacksonville, FL 32204-4762
Phone
(904) 387-9577
Fax
(904) 387-9245
NPI assigned
Jun 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 11019343 FL
Family Nurse Practitioner 363LF0000X APRN11019343 FL Primary

Addresses

Primary practice location

2 Shircliff Way Ste 600
Jacksonville, FL 32204-4762

Mailing address

PO Box 748817
Atlanta, GA 30374-8817
Phone (813) 286-0033

Other practice location 1

3 Shircliff Way Ste 200
Jacksonville, FL 32204-4785
Phone (904) 384-6622

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
I20220721002889 FL Practitioner - Nurse Practitioner 4981085941 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
Womens Care Florida LLCGroup PAC ID 9234031444, 324 clinicians

Practice addresses (Care Compare)

1232 King St
Jacksonville, FL 32204-4212
Phone (904) 821-7556

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11019343FLMDFamily Nurse Practitioner
11019343FLMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Care Florida LLC Nurse Practitioner CurrentSince Jul 1, 2022 Accepting new patients
Womens' Health Hospitalists, LLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

9404 Waypoint Pl
Jacksonville, FL 32257
Phone (904) 260-2255

3 Shircliff Way
Ste 200
Jacksonville, FL 32204
Phone (904) 308-6463

1232 King St
Jacksonville, FL 32204
Phone (904) 384-3699

2363 Dunn Ave
Ste 23631
Jacksonville, FL 32218
Phone (904) 757-2234

2 Shircliff Way
Ste 600
Jacksonville, FL 32204
Phone (904) 387-2200

2363 Dunn Ave
Jacksonville, FL 32218
Phone (904) 751-6030

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

5002 W Lemon St
Tampa, FL 33609

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

Interoperability endpoints

  • Direct secure messaging: tiffany.pereau@wcfnf.eclinicaldirectplus.com

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": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1255063509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY STE 600",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044762",
            "telephone_number": "904-387-9577",
            "fax_number": "904-387-9245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Shircliff Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044785",
            "country_code": "US",
            "telephone_number": "904-384-6622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREAU",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "11019343",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11019343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.