Organization Active NPI

Gratia Advanced Health Practice L.L.C.

  • Psychiatric/Mental Health Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1588359467
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
GRATIA ADVANCED HEALTH PRACTICE L.L.C.
Practice address
2054 Vista Pkwy Ste 400
West Palm Beach, FL 33411-6742
Phone
(321) 261-2009
NPI assigned
Apr 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Authorized official

Name
Vladymir Gratia, ARNPNPI 1760024871
Title
Owner
Phone
(561) 783-3739

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2054 Vista Pkwy Ste 400
West Palm Beach, FL 33411-6742

Mailing address

2054 Vista Pkwy Ste 400
West Palm Beach, FL 33411-6742
Phone (561) 783-3739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230609001053 FL Part B Supplier - Clinic/Group Practice 7719344589 Receives reassigned benefits from 1 practitioner
Practice locations: West Palm BCH, FL

National Provider Directory

National Provider Directory

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1588359467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2054 VISTA PKWY STE 400",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334116742",
            "telephone_number": "561-783-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2054 VISTA PKWY STE 400",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334116742",
            "telephone_number": "321-261-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRATIA ADVANCED HEALTH PRACTICE L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "GRATIA",
        "authorized_official_first_name": "VLADYMIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-783-3739",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.