Individual provider Active NPI

Jean Bernard Fleuristal

  • Family Nurse Practitioner
  • Haines City, FL
National Provider Identifier
1447609094
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9162372 Issued in FL
Practice address
705 Ingraham Ave
Haines City, FL 33844-4327
Phone
(866) 234-8534
NPI assigned
Jun 5, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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 ARNP9162372 FL Primary

Addresses

Primary practice location

705 Ingraham Ave
Haines City, FL 33844-4327

Mailing address

47 5TH St NW
Winter Haven, FL 33881-4672
Phone (863) 268-7850

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
I20190503002250 FL Practitioner - Nurse Practitioner 2668714023 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

1324 Lakeland Hill Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.12 of 100Reported as group
Quality
64.08
Promoting interoperability
98
Improvement activities
40
Cost
76.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9162372FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Health Care, Inc CurrentSince Mar 12, 2019 Accepting new patients
Central Florida Health Care, Inc. Current Accepting new patients
Central Florida Health Care, Inc CurrentSince Mar 12, 2019 Accepting new patients
Lakeland Regional Health Systems, Inc. CurrentSince May 1, 2023 Accepting new patients

Locations

950 County Road 17A W
Avon Park, FL 33825
Phone (863) 452-3000

109 W Wall St
Frostproof, FL 33843
Phone (863) 635-4891

705 Ingraham Ave
Haines City, FL 33844
Phone (863) 291-3314

305 W Central Ave
Fl Heal
Lake Wales, FL 33853

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

1129 N Missouri Ave
Lakeland, FL 33805
Phone (863) 413-8600

47 5th St NW
Winter Haven, FL 33881

1514 1st St N
Winter Haven, FL 33881
Phone (863) 291-5110

Interoperability endpoints

  • Direct secure messaging: jfleuristal51249@lrhs.direct-ci.com

Organizations & group practices 5

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 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": "1465084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1447609094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 5TH ST NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814672",
            "telephone_number": "863-268-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 INGRAHAM AVE",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338444327",
            "telephone_number": "866-234-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEURISTAL",
        "first_name": "JEAN",
        "middle_name": "BERNARD",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-05",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9162372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haines City, FL

Sources for this page

Verify at the official NPI Registry.