Individual provider Active NPI

Grace Marie Taddei, APRN

  • Family Nurse Practitioner
  • Ft Lauderdale, FL
National Provider Identifier
1295593671
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11031695 Issued in FL
Practice address
3300 S University Dr
Ft Lauderdale, FL 33328-2004
Phone
(407) 697-6767
NPI assigned
Mar 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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 11031695 FL Primary

Addresses

Primary practice location

3300 S University Dr
Ft Lauderdale, FL 33328-2004

Mailing address

3300 S University Dr
Ft Lauderdale, FL 33328-2004

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
I20240726002888 FL Practitioner - Nurse Practitioner 5799221644 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
Peter a Koretsky MD PAGroup PAC ID 6406874601, 3 clinicians

Practice addresses (Care Compare)

2955 Pineda Plaza Way
Suite 115
Melbourne, FL 32940-7306
Phone (321) 254-7375

Hospital & facility affiliations

  • Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
  • Viera Hospital Hospital, Melbourne, FL, CCN 100315
  • Palm Bay Hospital Hospital, Palm Bay, FL, CCN 100316

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11031695FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peter a Koretsky MD PA CurrentSince May 22, 2024 Accepting new patients

Locations

2955 Pineda Plaza Way
Ste 115
Melbourne, FL 32940
Phone (321) 254-7375

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 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": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1295593671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S UNIVERSITY DR",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333282004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 S UNIVERSITY DR",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333282004",
            "telephone_number": "407-697-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADDEI",
        "first_name": "GRACE",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11031695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.