Individual provider Active NPI

Melissa Ann Gonzalez, DNP, APRN, FNP-BC

  • Nurse Practitioner
  • Fort Pierce, FL
National Provider Identifier
1619348125
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9325897 Issued in FL
Practice address
2402 Frist Blvd Ste 201
Fort Pierce, FL 34950-4838
Phone
(772) 460-8838
NPI assigned
Oct 9, 2015
Last updated
Jun 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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 APRN9325897 FL Primary

Addresses

Primary practice location

2402 Frist Blvd Ste 201
Fort Pierce, FL 34950-4838

Mailing address

501 SW Bradshaw Cir
Port Saint Lucie, FL 34953-5535
Phone (772) 607-3531

Other identifiers 1

IdentifierTypeStateIssuer
APRN9325897OtherFLSTATE LICENSE

Other names 1

  • Melissa Eha 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
I20200213002074 FL Practitioner - Nurse Practitioner 4183050982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Broward Neurosurgeons LLCGroup PAC ID 8123096690, 21 clinicians

Practice addresses (Care Compare)

2402 Frist Blvd
Suite 201
Fort Pierce, FL 34950-4838
Phone (772) 252-6620

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9325897FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Broward Neurosurgeons LLC CurrentSince Jul 17, 2023 Accepting new patients
Infinite Medical PC Nurse Practitioner Past Accepting new patients
Palm Beach Atlantic University Past Accepting new patients

Locations

2402 Frist Blvd
Ste 201
Fort Pierce, FL 34950
Phone (772) 252-6620

2801 N State Road 7
Margate, FL 33063
Phone (954) 683-7041

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: melissa.gonzalez@hca4.eclinicaldirectplus.com

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": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1619348125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SW BRADSHAW CIR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349535535",
            "telephone_number": "772-607-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 FRIST BLVD STE 201",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504838",
            "telephone_number": "772-460-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "DNP, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9325897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "APRN9325897",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "EHA",
            "credential": "DNP, APRN, FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.