Individual provider Active NPI

Cathy Dionisio, APRN

  • Family Nurse Practitioner
  • Port Saint Lucie, FL
National Provider Identifier
1407220221
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9296568 Issued in FL
Practice address
451 SW Bethany Dr Ste 100
Port Saint Lucie, FL 34986-1964
Phone
(772) 204-0795
NPI assigned
Nov 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9296568 FL Primary

Addresses

Primary practice location

451 SW Bethany Dr Ste 100
Port Saint Lucie, FL 34986-1964

Mailing address

973 SW General Patton Ter
Port Saint Lucie, FL 34953-2604

Other practice location 1

8515 S US Highway 1 Ste 3
Port Saint Lucie, FL 34952-3346
Phone (772) 380-4042

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
I20230622003723 FL Practitioner - Physician Assistant 3678931631 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
ARNP9296568FLMDFamily Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1407220221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "973 SW GENERAL PATTON TER",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 SW BETHANY DR STE 100",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861964",
            "telephone_number": "772-204-0795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8515 S US Highway 1 Ste 3",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "349523346",
            "country_code": "US",
            "telephone_number": "772-380-4042",
            "fax_number": "772-380-4043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIONISIO",
        "first_name": "CATHY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9296568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.