Individual provider Active NPI

Micaela Nicole Wolfe

  • Nurse Practitioner
  • Stuart, FL
National Provider Identifier
1619520764
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11003301 Issued in FL
Practice address
200 SE Hospital Ave
Stuart, FL 34994-2346
Phone
(772) 223-5945
NPI assigned
Jul 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X APRN11003301 FL
Nurse Practitioner 363L00000X 11003301 FL Primary

Addresses

Primary practice location

200 SE Hospital Ave
Stuart, FL 34994-2346

Mailing address

1103 NE Pine Hill Ter
Jensen Beach, FL 34957-3786

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
I20190920000127 FL Practitioner - Nurse Practitioner 0042540817 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Romagosa Dermatology Group LLCGroup PAC ID 8022041565, 11 clinicians
Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

2220 SE Ocean Blvd
Suite 301
Stuart, FL 34996-3301
Phone (772) 220-3339

2426 S Tamiami TRL
Sarasota, FL 34239-3842
Phone (941) 955-0360

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11003301FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Water'S Edge Dermatology, LLC Dermatology CurrentSince Mar 1, 2020 Accepting new patients
Romagosa Dermatology Group LLC Dermatology CurrentSince Feb 17, 2026 Accepting new patients
Water'S Edge Dermatology, LLC CurrentSince Mar 1, 2020 Accepting new patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince Jan 1, 2022 Accepting new patients
Aqua Dermatology of Florida, PA Dermatology CurrentSince Jan 1, 2022 Accepting new patients

Locations

5101 Okeechobee Rd
Fort Pierce, FL 34947
Phone (772) 595-5995

3498 NW Federal Hwy
Jensen Beach, FL 34957
Phone (772) 219-1080

6250 Lantana Rd
Ste 9
Lake Worth, FL 33463
Phone (561) 578-8100

3659 S Miami Ave
Ste 6008
Miami, FL 33133
Phone (305) 854-5432

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

261 9th St S
Naples, FL 34102
Phone (239) 216-4337

14840 Tamiami Trl
North Port, FL 34287
Phone (941) 564-1542

301 NE 19th Dr
Okeechobee, FL 34972
Phone (863) 357-0039

600 Village Square Xing
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

2845 Pga Blvd
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

1400 SE Goldtree Dr
Ste 107
Port St Lucie, FL 34952
Phone (772) 217-6551

2426 S Tamiami Trl
Sarasota, FL 34239
Phone (507) 398-2753

264 NW Peacock Blvd
Ste 201
St Lucie West, FL 34986
Phone (772) 323-2321

2220 SE Ocean Blvd
Ste 203
Stuart, FL 34996
Phone (772) 220-3339

2220 SE Ocean Blvd
Ste 301
Stuart, FL 34996
Phone (772) 220-3339

805 37th Pl
Vero Beach, FL 32960
Phone (772) 257-7373

38162 Medical Center Ave
Zephyrhills, FL 33540
Phone (813) 782-2165

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mwolfe@aquadermatology.emadirect.md

Organizations & group practices 5

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": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1619520764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 NE PINE HILL TER",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349573786"
        },
        {
            "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": "772-223-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "MICAELA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "APRN11003301",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11003301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.