Individual provider Active NPI

Maryellen Meiring, ARNP

  • Nurse Practitioner
  • Bradenton, FL
National Provider Identifier
1487638243
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP 9227879 Issued in FL
Practice address
4351 Cortez Rd W Ste 200
Bradenton, FL 34210-3217
Phone
(941) 345-1950
Fax
(941) 345-1951
NPI assigned
Dec 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP 9227879 FL Primary

Addresses

Primary practice location

4351 Cortez Rd W Ste 200
Bradenton, FL 34210-3217

Mailing address

4351 Cortez Rd W Ste 200
Bradenton, FL 34210-3217
Phone (941) 345-1950

Other identifiers 2

IdentifierTypeStateIssuer
003051800MedicaidFL
Y04RAOtherFLBLUE CROSS BLUE SHIELD

Other names 1

  • Maryellen Hanusa Former name

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
I20051123000316 FL Practitioner - Nurse Practitioner 1153341920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Cardiovascular Consultants PLLCGroup PAC ID 5395050355, 4 clinicians

Practice addresses (Care Compare)

4351 Cortez Rd W
Suite 200
Bradenton, FL 34210-3217
Phone (941) 345-1950

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 9227879FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Cardiovascular Consultants PLLC CurrentSince Jul 15, 2015 Accepting new patients
Bayside Gynecology & Assoc Past Accepting new patients
Healthcare America Medical Group, Inc. Past Accepting new patients

Locations

3904 Cortez Rd W
Bradenton, FL 34210
Phone (941) 345-1943

4351 Cortez Rd W
Ste 200
Bradenton, FL 34210
Phone (941) 345-1950

2020 59th St W
Bradenton, FL 34209
Phone (813) 798-6303

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: maryellen.meiring@cccbra.eclinicaldirectplus.com

Organizations & group practices 3

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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1487638243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 CORTEZ RD W STE 200",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342103217",
            "telephone_number": "941-345-1950",
            "fax_number": "941-345-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 CORTEZ RD W STE 200",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342103217",
            "telephone_number": "941-345-1950",
            "fax_number": "941-345-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEIRING",
        "first_name": "MARYELLEN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 9227879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003051800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y04RA",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYELLEN",
            "last_name": "HANUSA",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.