Individual provider Active NPI

Amy L Cutshall, NP

  • Family Nurse Practitioner
  • Port Saint Lucie, FL
National Provider Identifier
1578214169
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11034607 Issued in FL
Practice address
1300 SW Saint Lucie West Blvd
Port Saint Lucie, FL 34986-2109
Phone
(219) 464-2141
NPI assigned
Jan 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71011990A IN
Family Nurse Practitioner 363LF0000X 11034607 FL Primary

Addresses

Primary practice location

1300 SW Saint Lucie West Blvd
Port Saint Lucie, FL 34986-2109

Mailing address

11405 Plattner Dr
Mokena, IL 60448-9231
Phone (219) 333-6983

Other practice location 1

1805 Calumet Ave
Valparaiso, IN 46383-3130
Phone (866) 389-2727

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
I20250407003770 FL Practitioner - Nurse Practitioner 8628455433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

1300 SW St Lucie Blvd
Port St Lucie, FL 34986-2109
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11034607FLMDFamily Nurse Practitioner
71011990AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Nurse Practitioner CurrentSince Mar 31, 2025 Accepting new patients

Locations

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

1300 SW Saint Lucie West Blvd
Port St Lucie, FL 34986
Phone (772) 878-7078

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Organizations & group practices 1

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": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1578214169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11405 PLATTNER DR",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489231",
            "telephone_number": "219-333-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SW SAINT LUCIE WEST BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862109",
            "telephone_number": "219-464-2141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1805 Calumet Ave",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463833130",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUTSHALL",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-14",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011990A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11034607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.