NPIMap

Organization Active NPI

M Care Medical Center Inc.

  • Family Medicine Physician
  • Fort Pierce, FL
National Provider Identifier
1396166252
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
M CARE MEDICAL CENTER INC.
Practice address
3501 Orange Ave
Fort Pierce, FL 34947-3523
Phone
(772) 252-4872
Fax
(772) 252-4873
NPI assigned
Dec 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Authorized official

Name
Manette Emilcare, RN
Title
President
Phone
(772) 252-4872

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X P13000065004 FL
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

3501 Orange Ave
Fort Pierce, FL 34947-3523

Mailing address

3501 Orange Ave
Fort Pierce, FL 34947-3523
Phone (772) 252-4872

Other identifiers 1

IdentifierTypeStateIssuer
016139500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150930001253 FL Part B Supplier - Clinic/Group Practice 3971811613 Receives reassigned benefits from 7 practitioners
Practice locations: Fort Pierce, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2077692M Care Medical Center3501 Orange Ave, Fort Pierce, FL 34947Certificate of waiverMay 12, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1396166252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 ORANGE AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349473523",
            "telephone_number": "772-252-4872",
            "fax_number": "772-252-4873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 ORANGE AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349473523",
            "telephone_number": "772-252-4872",
            "fax_number": "772-252-4873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M CARE MEDICAL CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-19",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A",
        "authorized_official_last_name": "EMILCARE",
        "authorized_official_first_name": "MANETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-252-4872",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "P13000065004",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016139500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.