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Individual provider Active NPI

Laurie Ann Tacey, FNP

  • Family Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1437767464
Registry record updated Jan 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11008127 Issued in FL
Practice address
3270 Suntree Blvd
Melbourne, FL 32940-7530
Phone
(321) 622-4877
Fax
(833) 291-9415
NPI assigned
Jul 15, 2020
Last updated
Jan 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2026

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 APRN11008127 FL Primary

Addresses

Primary practice location

3270 Suntree Blvd
Melbourne, FL 32940-7530

Mailing address

3772 Stream Dr
Melbourne, FL 32940-1101
Phone (321) 305-1139

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
I20200917001279 FL Practitioner - Nurse Practitioner 9830517259 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
Telehealth
Offers telehealth services
Group practices
Advanced Healthcare Integration LLCGroup PAC ID 3476964438, 7 clinicians

Practice addresses (Care Compare)

3270 Suntree Blvd
Suite 208
Melbourne, FL 32940-7505
Phone (321) 622-4877

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11008127FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psgfl MSSP, LLC CurrentSince Jul 28, 2025 Accepting new patients
Advanced Healthcare Integration LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

3270 Suntree Blvd
Ste 208
Melbourne, FL 32940
Phone (321) 622-4877

8325 University Pkwy
Ste A
Pensacola, FL 32514
Phone (850) 324-9633

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768608000000",
    "number": "1437767464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3772 STREAM DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401101",
            "telephone_number": "321-305-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 SUNTREE BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407530",
            "telephone_number": "321-622-4877",
            "fax_number": "833-291-9415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACEY",
        "first_name": "LAURIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2026-01-17",
        "certification_date": "2026-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.