Jack Facundus, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN2824142 Issued in FL

Practice address

651 W Warren Ave Ste 100
Longwood, FL 32750-4036

Phone

(321) 999-9617

NPI assigned

Sep 26, 2016

Last updated

Jun 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NH, FL2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.66 of 100Reported as apm

Quality

53.51

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NH, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Aspire Health Partners, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Orlando, FL
  • NPI 1821033903
  Medicare reassignment NPD
• Cheshire Medical Center

  • Emergency Medicine Physician
  • Keene, NH
  • NPI 1093803397
  Medicare reassignment NPD
• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198
  Medicare reassignment NPD
• CRC Health Treatment Clinics, LLC

  dba Panhandle Comprehensive Treatment Center

  • Methadone Clinic
  • Pace, FL
  • NPI 1902405749
  NPD
• Cheshire Medical Center

  dba Cheshire Medical Center Professional Services

  • Family Medicine Physician
  • Keene, NH
  • NPI 1306349444
  NPD
• Dartmouth-Hitchcock Clinic

  dba The Doorway at Dartmouth-Hitchcock Lebanon

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lebanon, NH
  • NPI 1124681846
  NPD
• Mary Hitchcock Memorial Hospital

  dba Cheshire Medical Center Pharmacy

  • Community/Retail Pharmacy
  • Keene, NH
  • NPI 1033761739
  NPD
• Confidant Providers LLC

  dba Confidant Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Reston, VA
  • NPI 1336761691

  Family

  NPD (past)
• Confidant Texas PA

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
  • NPI 1578282554

  Family

  NPD (past)

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1376092809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 ADANSON ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328041317",
            "telephone_number": "407-875-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 W WARREN AVE STE 100",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504036",
            "telephone_number": "321-999-9617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Berkshire Ave",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327895403",
            "country_code": "US",
            "telephone_number": "407-760-9605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "919 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "FL",
            "postal_code": "32771",
            "country_code": "US",
            "telephone_number": "407-875-3700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037560001",
            "country_code": "US",
            "telephone_number": "603-650-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 Railroad St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034313744",
            "country_code": "US",
            "telephone_number": "603-354-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FACUNDUS",
        "first_name": "JACK",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-26",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP2824142",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "090740-23",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN2824142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION PROGRAM",
            "identifier": "F0416038",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA ARNP LICENSE",
            "identifier": "ARNP2824142",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eye Physicians of Central Florida
• Eye Physicians of Central Florida
• Ez Healthcare and Counseling PLLC
• Gail Marie Ezell, MSN,RN,CPNP,ARNP
• F.S.T. LLC
• Staci L Faenza-Seward, MS
• Abrahim Fahs, DO
• Rachel Falkner Penn
• Santiago Fallon, LMHC
• Family Chiropractic of Central Florida

• Psychiatric/Mental Health Nurse Practitioner in Longwood, FL
• Providers in Longwood, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.