Individual provider Active NPI

Virginia Rusinova, DNP, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Port Saint Lucie, FL
National Provider Identifier
1396149886
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11037790 Issued in FL
Practice address
11380 SW Village Pkwy Ste 100
Port Saint Lucie, FL 34987-2389
Phone
(772) 301-6500
NPI assigned
Oct 14, 2014
Last updated
Apr 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN11037790 FL Primary
Gerontology Nurse Practitioner 363LG0600X APRN11037790 FL

Addresses

Primary practice location

11380 SW Village Pkwy Ste 100
Port Saint Lucie, FL 34987-2389

Mailing address

11380 SW Village Pkwy Ste 100
Port St Lucie, FL 34987-2389
Phone (772) 301-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11037790FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lightbridge Hospice, LLC PastSince Nov 17, 2014 Accepting new patients
Vitas Healthcare Corporation of Florida Past Accepting new patients

Organizations & group practices 2

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": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1396149886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11380 SW VILLAGE PKWY STE 100",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872389",
            "telephone_number": "772-301-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11380 SW VILLAGE PKWY STE 100",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872389",
            "telephone_number": "772-301-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSINOVA",
        "first_name": "VIRGINIA",
        "name_prefix": "Dr.",
        "credential": "DNP, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11037790",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11037790",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.