Individual provider Active NPI

Maryellen Neal, ARNP

  • Primary Care Nurse Practitioner
  • Gulf Breeze, FL
National Provider Identifier
1508838616
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1704722 Issued in FL
Practice address
1354 Country Club Rd
Gulf Breeze, FL 32563-3471
Phone
(850) 916-1636
Fax
(850) 916-1350
NPI assigned
Feb 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1704722 FL Primary

Addresses

Primary practice location

1354 Country Club Rd
Gulf Breeze, FL 32563-3471

Mailing address

2896 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-3146
Phone (850) 932-2203

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
I20100315000414 FL Practitioner - Nurse Practitioner 5294860375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Medical Group LLCGroup PAC ID 9638215734, 258 clinicians

Practice addresses (Care Compare)

2896 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-3146
Phone (448) 227-5499

9400 University Pkwy
Pensacola, FL 32514-5485

Hospital & facility affiliations

  • Peoples Home Health LLC Home health agency, Pensacola, FL, CCN 109664
  • Baptist Home Health Care Home health agency, Pensacola, FL, CCN 107006
  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093
  • Gulf Breeze Hospital Hospital, Gulf Breeze, FL, CCN 100266
  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025

Merit-based Incentive Payment System (MIPS)

Final score
81.01 of 100Reported as group
Quality
62.34
Promoting interoperability
95
Improvement activities
40
Cost
78.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1704722FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Medical Group LLC CurrentSince Apr 1, 2017 Accepting new patients
Baptist Medical Group LLC CurrentSince Apr 1, 2017 Accepting new patients

Locations

2896 Gulf Breeze Pkwy
Gulf Breeze, FL 32563
Phone (850) 932-2203

9400 University Pkwy
Ste 409
Pensacola, FL 32514
Phone (850) 994-7256

Organizations & group practices 2

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 5

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1508838616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2896 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325633146",
            "telephone_number": "850-932-2203",
            "fax_number": "850-934-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 COUNTRY CLUB RD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325633471",
            "telephone_number": "850-916-1636",
            "fax_number": "850-916-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "MARYELLEN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "1704722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

Verify at the official NPI Registry.