Individual provider Active NPI

Renaldia Ulysse

  • Psychiatric/Mental Health Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1497634935
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11041943 Issued in FL
Practice address
212 SE Via Visconti
Port St Lucie, FL 34952-5321
Phone
(772) 259-0844
NPI assigned
Aug 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11041943 FL Primary

Addresses

Primary practice location

212 SE Via Visconti
Port St Lucie, FL 34952-5321

Mailing address

212 SE Via Visconti
Port St Lucie, FL 34952-5321
Phone (772) 259-0844

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
I20251021004184 FL Practitioner - Nurse Practitioner 5890283915 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Quality BHS Florida LLCGroup PAC ID 4082030721, 26 clinicians
Nxpath Psychiatry LLCGroup PAC ID 0345692364, 13 clinicians

Practice addresses (Care Compare)

100 S Ashley Dr
Suite 600
Tampa, FL 33602-5300
Phone (305) 250-2435

11355 131St St
Largo, FL 33774-4716
Phone (813) 325-7479

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11041943FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quality BHS Florida, LLC Psychiatric/Mental Health CurrentSince Oct 7, 2025 Accepting new patients
Telos Health Systems FL LLC Psychiatric/Mental Health CurrentSince Nov 3, 2025 Accepting new patients
Nxpath Psychiatry LLC CurrentSince Nov 1, 2025 Accepting new patients

Locations

4250 66th St N
Kenneth City, FL 33709
Phone (350) 250-2435

5860 W Junior College Rd
Key West, FL 33040
Phone (305) 293-1299

615 Crescent Executive Ct
Ste 100
Lake Mary, FL 32746
Phone (201) 217-6777

11355 131st St
Largo, FL 33774
Phone (813) 325-7479

1501 SE 24th Rd
Ocala, FL 34471
Phone (352) 257-7777

100 S Ashley Dr
Ste 600
Tampa, FL 33602
Phone (813) 766-4218

2180 10th Ave
Vero Beach, FL 32960
Phone (772) 564-9511

980 Sylvan Ave
Englewood Cliffs, NJ 07632
Phone (201) 217-6777

Interoperability endpoints

  • Direct secure messaging: renaldia.ulysse.1@25403.direct.athenahealth.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": "1756339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1497634935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 SE VIA VISCONTI",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525321",
            "telephone_number": "772-259-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 SE VIA VISCONTI",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525321",
            "telephone_number": "772-259-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULYSSE",
        "first_name": "RENALDIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11041943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.