Jeanne Marie Dyckman, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

APRN11008805 Issued in FL

Practice address

12471 McGregor Blvd Apt 9
Fort Myers, FL 33919-3155

Phone

(239) 213-8610

NPI assigned

Jun 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, FL2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wound Care Physicians of Tampa Bay LLCGroup PAC ID 6002344272, 8 clinicians

Heal Precisely of Northside LLCGroup PAC ID 9537544853, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.65 of 100Reported as group

Quality

95

Improvement activities

40

Cost

75.5

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Heal Precisely of Northside LLC

  • General Practice Physician
  • St Petersburg, FL
  • NPI 1093433674
  Medicare reassignment Care Compare group NPD
• Wound Care Physicians of Tampa Bay LLC

  • Wound Care Registered Nurse
  • St Petersburg, FL
  • NPI 1245056522
  Medicare reassignment Care Compare group NPD
• Vein Specialists at Royal Palm Square Inc

  • Vascular Surgery Physician
  • Fort Myers, FL
  • NPI 1124205349
  Medicare reassignment NPD
• Consonant Healing Medical Associates

  • Surgery Physician
  • Silver Spring, MD
  • NPI 1588122535

  VA

  Medicare reassignment NPD

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1487270971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12471 MCGREGOR BLVD APT 9",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193155",
            "telephone_number": "239-213-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12471 MCGREGOR BLVD APT 9",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193155",
            "telephone_number": "239-213-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYCKMAN",
        "first_name": "JEANNE",
        "middle_name": "MARIE",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9272229",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11008805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dva Healthcare Renal Care Inc (Fort Myers South Dialysis)
• Dva Healthcare Renal Care Inc (Fort Myers Dialysis)
• Lauren Dvorak
• Dwic of Tampa Bay, Inc (MedExpress Urgent Care - Fort Myers, S Cleveland Ave)
• Brendan Mark Dwyer, DDS
• Joyce Dyer
• Valerie R. Dyke, MD
• Kelly Dylik, APRN FNP-C
• Heidi Dymowski
• Dynamic Dental Health Associates of Florida, PA (The Smile Studio)

• Acute Care Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Acute Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.