Individual provider Active NPI

Nestor Lacayo, MD

  • Family Medicine Physician
  • Port Saint Lucie, FL
National Provider Identifier
1508872037
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME42949 Issued in FL
Practice address
513 NW Lake Whitney PL Ste 101
Port Saint Lucie, FL 34986-1618
Phone
(772) 344-7228
Fax
(773) 344-7158
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME42949 FL Primary

Addresses

Primary practice location

513 NW Lake Whitney PL Ste 101
Port Saint Lucie, FL 34986-1618

Mailing address

513 NW Lake Whitney PL Ste 101
Port Saint Lucie, FL 34986-1618
Phone (772) 344-7228

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040616001002 FL Practitioner - Family Practice 5698759645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME42949FLMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1508872037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 NW LAKE WHITNEY PL STE 101",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861618",
            "telephone_number": "772-344-7228",
            "fax_number": "773-344-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 NW LAKE WHITNEY PL STE 101",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861618",
            "telephone_number": "772-344-7228",
            "fax_number": "773-344-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACAYO",
        "first_name": "NESTOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME42949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.