Individual provider Active NPI

Estera Elizabeth Vatamaniuc, FNP-BC

  • Primary Care Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1396564803
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
2024062954 Issued in FL
Practice address
1832 Thomas St
Hollywood, FL 33020-2129
Phone
(773) 355-7018
NPI assigned
Oct 10, 2024
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 2024062954 FL Primary

Addresses

Primary practice location

1832 Thomas St
Hollywood, FL 33020-2129

Mailing address

1832 Thomas St
Hollywood, FL 33020-2129
Phone (773) 355-7018

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
I20250102003610 FL Practitioner - Nurse Practitioner 2466989439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Primary Care Solutions Jacksonville LLCGroup PAC ID 9739553207, 13 clinicians

Practice addresses (Care Compare)

42 Davin CT
Ponte Vedra Beach, FL 32082-1840
Phone (904) 490-0264

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024062954FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Solutions Jacksonville LLC CurrentSince Sep 23, 2024 Accepting new patients

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1396564803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1832 THOMAS ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330202129",
            "telephone_number": "773-355-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1832 THOMAS ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330202129",
            "telephone_number": "773-355-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VATAMANIUC",
        "first_name": "ESTERA",
        "middle_name": "ELIZABETH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "2024062954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.