Individual provider Active NPI

Hagelande P Vertus, APRN, AGNP-BC

  • Gerontology Nurse Practitioner
  • Jupiter, FL
National Provider Identifier
1336601442
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11000098 Issued in FL
Practice address
641 University Blvd Ste 211
Jupiter, FL 33458-2794
Phone
(561) 253-8121
NPI assigned
Apr 5, 2019
Last updated
Apr 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN11000098 FL Primary

Addresses

Primary practice location

641 University Blvd Ste 211
Jupiter, FL 33458-2794

Mailing address

7956 Picklewood Park Dr
Boynton Beach, FL 33437-7524
Phone (561) 843-5205

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address landy0209@hotmail.com Health Information Exchange (HIE)

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
I20200429000222 FL Practitioner - Nurse Practitioner 6305276668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney and Dialysis Specialists of the Palm Beaches PAGroup PAC ID 6507878923, 2 clinicians

Practice addresses (Care Compare)

2000 Continental Dr
Suite a
West Palm Beach, FL 33407-3207
Phone (561) 840-4141

927 45TH St
Suite 102
Mangonia Park, FL 33407-2450

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11000098FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney & Dialysis Specialists of the Palm Beaches, PA CurrentSince Sep 11, 2023 Accepting new patients

Locations

2000 Continental Dr
Ste A
West Palm Beach, FL 33407
Phone (561) 840-4141

5305 Greenwood Ave
Ste 102
West Palm Beach, FL 33407
Phone (561) 840-7779

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1336601442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7956 PICKLEWOOD PARK DR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334377524",
            "telephone_number": "561-843-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 UNIVERSITY BLVD STE 211",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582794",
            "telephone_number": "561-253-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERTUS",
        "first_name": "HAGELANDE",
        "middle_name": "P",
        "credential": "APRN, AGNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11000098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "landy0209@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "641 University Blvd Ste 211",
            "city": "Jupiter",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334582794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.