Individual provider Active NPI

Samantha Gloria Byrne, APRN

  • Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1295506764
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11030596 Issued in FL
Practice address
2200 W Eau Gallie Blvd Ste 200
Melbourne, FL 32935-3166
Phone
(321) 255-1500
Fax
(321) 254-0400
NPI assigned
Jan 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11030596 FL Primary

Addresses

Primary practice location

2200 W Eau Gallie Blvd Ste 200
Melbourne, FL 32935-3166

Mailing address

PO Box 361095
Melbourne, FL 32936-1095

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
I20240215003258 FL Practitioner - Nurse Practitioner 4284078411 Reassigns benefits to 3 organizations

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
Practitioners in Motion PLLCGroup PAC ID 9335456755, 9 clinicians

Practice addresses (Care Compare)

1900 S Harbor Blvd
Suite 232
Melbourne, FL 32901-3805
Phone (321) 216-2288

Hospital & facility affiliations

  • HCA Florida Healthcare at Home Home health agency, Fort Pierce, FL, CCN 107271
  • Activa Home Health Home health agency, Stuart, FL, CCN 108113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Total Care Medical Centers LLC CurrentSince Feb 13, 2024 Accepting new patients
Florida Health Care of Brevard CurrentSince Feb 13, 2024 Accepting new patients
Practitioners in Motion PLLC CurrentSince Jul 1, 2025 Accepting new patients
Medical Associates of Brevard LLC CurrentSince Jun 3, 2024 Accepting new patients

Locations

8200 S Jog Rd
Ste 205
Boynton Beach, FL 33472
Phone (561) 364-9584

2200 W Eau Gallie Blvd
Ste 200
Melbourne, FL 32935
Phone (321) 255-1500

1305 Hickory St
Melbourne, FL 32901
Phone (321) 255-1500

1785 Waverly Pl
Ste A
Melbourne, FL 32901
Phone (321) 216-2288

1840 Eldron Blvd SE
Ste 2
Palm Bay, FL 32909
Phone (561) 523-3973

3745 11th Cir
Ste 109
Vero Beach, FL 32960
Phone (321) 848-8889

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 3

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": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1295506764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361095",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329361095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W EAU GALLIE BLVD STE 200",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353166",
            "telephone_number": "321-255-1500",
            "fax_number": "321-254-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRNE",
        "first_name": "SAMANTHA",
        "middle_name": "GLORIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11030596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.