NPIMap

Individual provider Active NPI

Michelle Margaret Dicarlo, P.A.(PHYSICIAN ASSIS

  • Physician Assistant
  • Port St Lucie, FL
National Provider Identifier
1427099282
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9100784 Issued in FL
Practice address
1700 SE Hillmoor Drive
Suite 500
Port St. Lucie, FL 34957
Phone
(772) 335-9600
Fax
(772) 398-7951
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X PA9100784 FL Primary

Addresses

Primary practice location

1700 SE Hillmoor Drive
Suite 500
Port St. Lucie, FL 34957

Mailing address

6515 S Kanner Hwy
Stuart, FL 34997-6330
Phone (772) 461-1123

Other identifiers 2

IdentifierTypeStateIssuer
Y03APOtherFLBLUE CROSS AND BLUE SHIELD
000635000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090117000014 FL Practitioner - Physician Assistant 3577626555 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 SE Hospital Ave
Stuart, FL 34994-2346
Phone (772) 223-5665

3066 SW Martin Downs Blvd
Palm City, FL 34990-2683

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mecnb, LLC CurrentSince Mar 8, 2020 Accepting new patients
FL-I Medical Services, LLC Physician Assistant CurrentSince Jun 26, 2015 Accepting new patients
FL-I Medical Services LLC Physician Assistant CurrentSince Jun 26, 2015 Accepting new patients
Mecnb, LLC CurrentSince Mar 8, 2020 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Sheridan Emergency Physician Services Inc Physician Assistant CurrentSince Feb 1, 2016 Accepting new patients
Sheridan Emergency Physician Services Inc Physician Assistant CurrentSince Feb 1, 2016 Accepting new patients
Emcare Physician Providers, Inc. Past Accepting new patients
Hillmoor ER SVCS Partnership Past Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

1210 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 743-5073

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

6515 S Kanner Hwy
Stuart, FL 34997
Phone (772) 463-1123

225 S US Highway 1
Tequesta, FL 33469
Phone (561) 747-4464

Interoperability endpoints

  • Direct secure messaging: mdicarlo2496256@direct.ccf.org

Organizations & group practices 12

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.

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1427099282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6515 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349976330",
            "telephone_number": "772-461-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SE HILLMOOR DRIVE",
            "address_2": "SUITE 500",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34957",
            "telephone_number": "772-335-9600",
            "fax_number": "772-398-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICARLO",
        "first_name": "MICHELLE",
        "middle_name": "MARGARET",
        "name_prefix": "Mrs.",
        "credential": "P.A.(PHYSICIAN ASSIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9100784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE  SHIELD",
            "identifier": "Y03AP",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000635000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.