Individual provider Active NPI

Vanessa Alessandra Burgos, ARNP, FNP-C

  • Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1497536601
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11029029 Issued in FL
Practice address
10000 SW Innovation Way
Port St Lucie, FL 34987-2111
Phone
(772) 345-8100
NPI assigned
Oct 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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 APRN11029029 FL Primary

Addresses

Primary practice location

10000 SW Innovation Way
Port St Lucie, FL 34987-2111

Mailing address

8798 SW 18TH Ave
Stuart, FL 34997-7907
Phone (772) 260-6572

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
I20240228003247 FL Practitioner - Nurse Practitioner 3577908672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Contracting Services LLCGroup PAC ID 3971417825, 404 clinicians

Practice addresses (Care Compare)

1095 NW Saint Lucie W Blvd
Port Saint Lucie, FL 34986-1719
Phone (772) 785-5555

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Contracting Services LLC Nurse Practitioner CurrentSince Mar 1, 2024 Accepting new patients

Locations

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

10000 SW Innovation Way
Port St Lucie, FL 34987
Phone (772) 288-5853

1095 NW Saint Lucie West Blvd
Port St Lucie, FL 34986
Phone (772) 785-5500

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

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": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1497536601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8798 SW 18TH AVE",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977907",
            "telephone_number": "772-260-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SW INNOVATION WAY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872111",
            "telephone_number": "772-345-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS",
        "first_name": "VANESSA",
        "middle_name": "ALESSANDRA",
        "credential": "ARNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-12",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11029029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.