Individual provider Active NPI

Michael Delaneuville, ARNP

  • Primary Care Nurse Practitioner
  • Port Saint Lucie, FL
National Provider Identifier
1629488937
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
9266339 Issued in FL
Practice address
1811 SW Jamesport Dr
Port Saint Lucie, FL 34953-4599
Phone
(561) 312-3348
NPI assigned
May 8, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 9266339 FL
Gerontology Nurse Practitioner 363LG0600X 9266339 FL
Primary Care Nurse Practitioner 363LP2300X 9266339 FL Primary

Addresses

Primary practice location

1811 SW Jamesport Dr
Port Saint Lucie, FL 34953-4599

Mailing address

1094 Military TRL
Jupiter, FL 33458-7021
Phone (561) 622-6111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9266339FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
The Medical Group of South Florida, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mdelaneuville2496294@direct.ccf.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1629488937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1094 MILITARY TRL",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587021",
            "telephone_number": "561-622-6111",
            "fax_number": "855-215-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 SW JAMESPORT DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349534599",
            "telephone_number": "561-312-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELANEUVILLE",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-08",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9266339",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "9266339",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "9266339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.