Individual provider Active NPI

Nancy Laureano, PA-C

  • Medical Physician Assistant
  • Vero Beach, FL
National Provider Identifier
1316954902
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 9103378 Issued in FL
Practice address
1400 27TH St
Vero Beach, FL 32960-0303
Phone
(772) 257-8224
Fax
(772) 252-3245
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 9103378 FL Primary

Addresses

Primary practice location

1400 27TH St
Vero Beach, FL 32960-0303

Mailing address

1555 Indian River Blvd
Vero Beach, FL 32960-5639
Phone (772) 257-8224

Other identifiers 1

IdentifierTypeStateIssuer
PA9103378OtherFLSTATE LICENSE

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
I20050928000367 FL Practitioner - Physician Assistant 8224063367 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 9103378FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Treasure Coast Community Health Inc CurrentSince Dec 1, 2010 Accepting new patients
Treasure Coast Community Health Inc CurrentSince Mar 11, 2025 Accepting new patients
Treasure Coast Community Health Inc CurrentSince Dec 1, 2010 Accepting new patients
Brevard Emergency Services Past Accepting new patients
Treasure Coast Community Health Inc Past Accepting new patients

Locations

12196 County Road 512
Fellsmere, FL 32948
Phone (561) 571-8828

44 N Pine St
Fellsmere, FL 32948

1545 9th St SW
Vero Beach, FL 32962
Phone 77225782241908

1400 27th St
Vero Beach, FL 32960

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71320

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1316954902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 INDIAN RIVER BLVD",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605639",
            "telephone_number": "772-257-8224",
            "fax_number": "772-252-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 27TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329600303",
            "telephone_number": "772-257-8224",
            "fax_number": "772-252-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUREANO",
        "first_name": "NANCY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9103378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA9103378",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.