Individual provider Active NPI

Paige Michelle Ahammer, ARNP

  • Adult Health Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1407073943
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP2838892 Issued in FL
Practice address
221 W Hibiscus Blvd
Suite 401
Melbourne, FL 32901-3044
Phone
(321) 258-9642
Fax
(321) 821-5365
NPI assigned
Apr 19, 2007
Last updated
Jul 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP2838892 FL Primary

Addresses

Primary practice location

221 W Hibiscus Blvd
Suite 401
Melbourne, FL 32901-3044

Mailing address

221 W Hibiscus Blvd
Suite 401
Melbourne, FL 32901-3044
Phone (321) 258-9642

Other identifiers 1

IdentifierTypeStateIssuer
MR540OtherFLMEDICARE PTAN

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
I20080731000418 FL Practitioner - Nurse Practitioner 3476627936 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Peter a Koretsky MD PAGroup PAC ID 6406874601, 3 clinicians

Practice addresses (Care Compare)

2955 Pineda Plaza Way
Suite 115
Melbourne, FL 32940-7306
Phone (321) 254-7375

3260 N Harbor City Blvd
Discovery Village
Melbourne, FL 32935-6203
Phone (321) 600-4747

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
ARNP2838892FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peter a Koretsky MD PA CurrentSince Jan 25, 2022 Accepting new patients
Patel Family Medicine PA CurrentSince Aug 22, 2017 Accepting new patients

Locations

221 W Hibiscus Blvd
Melbourne, FL 32901
Phone (321) 258-9642

2955 Pineda Plaza Way
Ste 115
Melbourne, FL 32940
Phone (321) 254-7375

469 N Harbor City Blvd
Melbourne, FL 32935
Phone (321) 254-2321

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.

Hospital & facility affiliations 1

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1407073943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W HIBISCUS BLVD",
            "address_2": "SUITE 401",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013044",
            "telephone_number": "321-258-9642",
            "fax_number": "321-821-5365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W HIBISCUS BLVD",
            "address_2": "SUITE 401",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013044",
            "telephone_number": "321-258-9642",
            "fax_number": "321-821-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHAMMER",
        "first_name": "PAIGE",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP2838892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MR540",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.