Individual provider Active NPI

Jesse Lee Mace, FNP-C

  • Family Nurse Practitioner
  • Vero Beach, FL
National Provider Identifier
1275975237
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9432066 Issued in FL
Practice address
3735 11TH Cir Ste 103
Vero Beach, FL 32960-4884
Phone
(772) 770-4888
NPI assigned
Jul 19, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9432066 FL
Family Nurse Practitioner 363LF0000X 9432066 FL Primary

Addresses

Primary practice location

3735 11TH Cir Ste 103
Vero Beach, FL 32960-4884

Mailing address

8116 Amalfi Cir
Fort Pierce, FL 34951-4400
Phone (772) 226-0425

Other practice location 1

8116 Amalfi Cir
Fort Pierce, FL 34951-4400
Phone (772) 226-0425

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
I20170105000728 FL Practitioner - Nurse Practitioner 2769619063 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Oceanside Health and Wellness LLCGroup PAC ID 3072986207, 2 clinicians

Practice addresses (Care Compare)

1910 82ND Ave
Suite 105
Vero Beach, FL 32966-6991
Phone (772) 226-0425

Hospital & facility affiliations

  • NHC Homecare Home health agency, Vero Beach, FL, CCN 107515
  • Pinnacle Home Care Home health agency, Port Saint Lucie, FL, CCN 109610
  • Concierge Home Care Home health agency, Port Saint Lucie, FL, CCN 687163
  • Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9432066FLMDFamily Nurse Practitioner
APRN9432066FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oceanside Health and Wellness LLC Family CurrentSince Jan 1, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1910 82nd Ave
Ste 105
Vero Beach, FL 32966
Phone (772) 226-0425

1800 43rd Ave
Vero Beach, FL 32960
Phone (772) 226-0425

Organizations & group practices 4

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 4

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": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1275975237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8116 AMALFI CIR",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349514400",
            "telephone_number": "772-226-0425",
            "fax_number": "949-437-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3735 11TH CIR STE 103",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604884",
            "telephone_number": "772-770-4888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8116 Amalfi Cir",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349514400",
            "country_code": "US",
            "telephone_number": "772-226-0425",
            "fax_number": "949-437-8585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACE",
        "first_name": "JESSE",
        "middle_name": "LEE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-19",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9432066",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9432066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.