Individual provider Active NPI

Juliana Escudero

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1255902946
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11027735 Issued in FL
Practice address
14071 Metropolis Ave
Fort Myers, FL 33912-4330
Phone
(239) 694-7546
Fax
(239) 694-1571
NPI assigned
Jul 5, 2021
Last updated
Sep 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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 11027735 FL Primary

Addresses

Primary practice location

14071 Metropolis Ave
Fort Myers, FL 33912-4330

Mailing address

14071 Metropolis Ave
Fort Myers, FL 33912-4330
Phone (239) 694-7546

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
I20230921000360 FL Practitioner - Nurse Practitioner 0941654214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14071 Metropolis Ave
Fort Myers, FL 33912-4330
Phone (239) 694-7546

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11027735FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Solutions a Profession Limited Liability Com CurrentSince Aug 21, 2023 Accepting new patients

Locations

14071 Metropolis Ave
Fort Myers, FL 33912
Phone (239) 694-7546

Organizations & group practices 1

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": "1625443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1255902946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14071 METROPOLIS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124330",
            "telephone_number": "239-694-7546",
            "fax_number": "239-694-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14071 METROPOLIS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124330",
            "telephone_number": "239-694-7546",
            "fax_number": "239-694-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCUDERO",
        "first_name": "JULIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-05",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11027735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.