Individual provider Active NPI

Marie Connell, ARNP

  • Family Nurse Practitioner
  • Boca Raton, FL
National Provider Identifier
1427674928
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11007672 Issued in FL
Practice address
777 Glades Rd
Boca Raton, FL 33431-6496
Phone
(352) 223-6858
NPI assigned
Jun 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 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 11007672 FL Primary

Addresses

Primary practice location

777 Glades Rd
Boca Raton, FL 33431-6496

Mailing address

777 Glades Rd
Boca Raton, FL 33431-6496
Phone (352) 223-6858

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
I20210114001371 FL Practitioner - Nurse Practitioner 6406269307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brevard Physician Associates PLLCGroup PAC ID 1850535048, 221 clinicians

Practice addresses (Care Compare)

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11007672FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Physician Associates, PLLC CurrentSince Dec 22, 2020 Accepting new patients

Locations

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

Interoperability endpoints

  • Direct secure messaging: mconnell71363@epicdirect.hf.org

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": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1427674928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 GLADES RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316496",
            "telephone_number": "352-223-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 GLADES RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316496",
            "telephone_number": "352-223-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "MARIE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.