Individual provider Active NPI

Judy R Dasilva, DNP, MSN, ARNP, FNP

  • Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1568405579
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP2136652 Issued in FL
Practice address
1095 NW St Lucie West Blvd
Port St Lucie, FL 34952-7564
Phone
(772) 785-5570
Fax
(772) 785-5553
NPI assigned
Jun 14, 2006
Last updated
Oct 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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 ARNP2136652 FL Primary

Addresses

Primary practice location

1095 NW St Lucie West Blvd
Port St Lucie, FL 34952-7564

Mailing address

PO Box 417
Stuart, FL 34995-0417
Phone (772) 223-2832

Other identifiers 1

IdentifierTypeStateIssuer
306082900MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdasilva4308@direct.martinhealth.org

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
I20040601000192 FL Practitioner - Nurse Practitioner 6103807524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1095 NW Saint Lucie W Blvd
Suite 104
Port Saint Lucie, FL 34986
Phone (772) 785-5511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Memorial Medical Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Coastal Care Corporation Past Accepting new patients

Locations

11600 SE Federal Hwy
Hobe Sound, FL 33455
Phone (772) 223-4940

3496 NW Federal Hwy
Ste C
Jensen Beach, FL 34957
Phone (772) 223-5630

1095 NW Saint Lucie West Blvd
Ste 104
Port St Lucie, FL 34986
Phone (772) 785-5511

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

3801 S Kanner Hwy
Ste 300
Stuart, FL 34994
Phone (772) 223-4978

Interoperability endpoints

  • Direct secure messaging: jdasilva2496269@direct.ccf.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1568405579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349950417",
            "telephone_number": "772-223-2832",
            "fax_number": "772-223-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 NW ST LUCIE WEST BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527564",
            "telephone_number": "772-785-5570",
            "fax_number": "772-785-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASILVA",
        "first_name": "JUDY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DNP, MSN, ARNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2136652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306082900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdasilva4308@direct.martinhealth.org",
            "affiliation": "N",
            "address_1": "1095 NW St Lucie West Blvd",
            "city": "Port St Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349527564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.