Active NPI
Michael Delaneuville, ARNP
- Primary Care Nurse Practitioner
- Port Saint Lucie, FL
National Provider Identifier
1629488937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 9266339
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 9266339 | FL | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Euclid Hospital Cleveland Clinic Health System | Current | Accepting new patients | |
| The Medical Group of South Florida, Inc | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- General Acute Care Hospital
- Euclid, OH
- NPI 1457403016
-
- Specialist
- West Palm Beach, FL
- NPI 1023454063
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.