Individual provider Active NPI

Emily Ann Perez

  • Gerontology Nurse Practitioner
  • Stuart, FL
National Provider Identifier
1609680065
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11036427 Issued in FL
Practice address
200 SE Hospital Ave
Stuart, FL 34994-2346
Phone
(772) 287-5200
NPI assigned
Feb 5, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11036427 FL
Gerontology Nurse Practitioner 363LG0600X APRN11036427 FL Primary

Addresses

Primary practice location

200 SE Hospital Ave
Stuart, FL 34994-2346

Mailing address

889 SE Courances Dr
Port Saint Lucie, FL 34984-6686
Phone (561) 284-2991

Other practice location 1

10000 SW Innovation Way
Port Saint Lucie, FL 34987-2111
Phone (772) 345-8100

Other names 1

  • Emily Ebersold Former name

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
I20250402000966 FL Practitioner - Nurse Practitioner 6901329754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 SE Hospital Ave
Stuart, FL 34994-2346
Phone (772) 223-5665

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Memorial Medical Center Inc CurrentSince Mar 24, 2025 Accepting new patients
Martin Memorial Medical Center Inc Current Accepting new patients

Locations

10000 SW Innovation Way
Port St Lucie, FL 34987
Phone (772) 288-5853

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

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1738713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1609680065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 SE COURANCES DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349846686",
            "telephone_number": "561-284-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SE HOSPITAL AVE",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942346",
            "telephone_number": "772-287-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10000 SW Innovation Way",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "349872111",
            "country_code": "US",
            "telephone_number": "772-345-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11036427",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11036427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "EBERSOLD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.