Monique M. Berces-Mardenly, FNP, MSN, MPH
Individual provider Active NPI Family Nurse Practitioner · Bunnell, FL
NPI 1528207552 · NPPES record last updated Jan 18, 2023
Key facts
- NPI
- 1528207552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN11002491 (FL)
- Practice address
- 301 Dr Carter Blvd
Bunnell, FL 32110-6212 - Phone
- (386) 437-7350
- Fax
- (386) 437-7353
- NPI assigned
- Feb 14, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Florida Department of Health
Practice addresses (Care Compare)
200 San Sebastian VW
Saint Augustine, FL 32084-8695
Phone (904) 506-6081
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211202002297 | FL | Practitioner - Nurse Practitioner | 2163579400 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Department of Health | Current |
Accepting new patients | |
| Holiday CVS L.L.C. | Past |
Accepting new patients |
Locations
200 San Sebastian Vw
Ste 1322
Saint Augustine, FL 32084
200 San Sebastian Vw
St Augustine, FL 32084
Phone (904) 209-3250
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 18296 | CA | |
| Family Nurse Practitioner | 363LF0000X | APRN11002491 | FL | Yes |
Addresses
Primary practice location
301 Dr Carter Blvd
Bunnell, FL 32110-6212
Mailing address
301 Dr Carter Blvd
Bunnell, FL 32110-6212
Phone (386) 437-7350
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0276496 | Other | WA | L AND I |
| 1528207552 | Medicaid | WA | |
| P01169704 | Other | WA | RAILROAD MEDICARE |
Other providers in Bunnell, FL
- Atlantic Hematology and Oncology Associates
- Virgil Wayne Baker
- Jamie B Bauroth
- Bee Well Health, LLC
- Devon Beneby
- Frances Elizabeth Bey
- Stephen R. Bickel
- Kristina H Blanchek
- Andrew Bliss
- Ronda Maria Bostick
All providers in Bunnell, FL · Family Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.