NPIMap

Individual provider Active NPI

Neil Johnathon Frey, APRN

  • Gerontology Nurse Practitioner
  • Palm Bay, FL
National Provider Identifier
1265093074
Registry record updated Jan 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11002739 Issued in FL
Practice address
341 Allison Dr
Palm Bay, FL 32908-6405
Phone
(321) 543-9830
Fax
(321) 256-6212
NPI assigned
Jun 23, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11002739 FL
Gerontology Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LG0600X APRN11002739 FL Primary

Addresses

Primary practice location

341 Allison Dr
Palm Bay, FL 32908-6405

Mailing address

341 Allison Dr
Palm Bay, FL 32908-6405
Phone (321) 282-1499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191106002549 FL Practitioner - Nurse Practitioner 5991137283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glomar Medical Inc 4 clinicians

Practice addresses (Care Compare)

442 New Ave NE
Palm Bay, FL 32907-2363
Phone (321) 282-1499

Hospital & facility affiliations

  • Elevate Home Health Group Home health agency, Lake Mary, FL, CCN 109733
  • Concierge Home Care Home health agency, Melbourne, FL, CCN 687040
  • Home Health Care of Florida Home health agency, Palm Shores, FL, CCN 103156
  • Trilogy Home Healthcare Home health agency, Orlando, FL, CCN 683131
  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11002739FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Glomar Medical Inc. Single Specialty CurrentSince Dec 7, 2020 Accepting new patients
Centennial Medical Group Single Specialty PastSince Mar 1, 2020 Accepting new patients

Locations

7365 Orchestra Ln
Melbourne, FL 32940
Phone (321) 253-7450

Interoperability endpoints

  • Direct secure messaging: neil.frey.1@23115.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23115/brand/1/csg/1/fhir/r4

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 8

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": "1561248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611964800000",
    "number": "1265093074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 ALLISON DR",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329086405",
            "telephone_number": "321-282-1499",
            "fax_number": "321-256-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 ALLISON DR",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329086405",
            "telephone_number": "321-543-9830",
            "fax_number": "321-256-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREY",
        "first_name": "NEIL",
        "middle_name": "JOHNATHON",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-23",
        "last_updated": "2021-01-30",
        "certification_date": "2021-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11002739",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11002739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.