Individual provider Active NPI

Andres Miguel Luque, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Boca Raton, FL
National Provider Identifier
1639055437
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11041704. Issued in FL
Practice address
9517 Boca River Cir FL 33434
Boca Raton, FL 33434-3955
Phone
(561) 609-7520
NPI assigned
Aug 15, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2025040376. FL
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X APRN11041704. FL Primary

Addresses

Primary practice location

9517 Boca River Cir FL 33434
Boca Raton, FL 33434-3955

Mailing address

9517 Boca River Cir FL 33434
Boca Raton, FL 33434-3955
Phone (561) 609-7520

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
I20251203001845 FL Practitioner - Nurse Practitioner 5496248973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Nova Southeastern College of Osteo Medicine, 2025
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Stedfast Medical Services LLCGroup PAC ID 4981000999, 46 clinicians

Practice addresses (Care Compare)

10301 Hagen Ranch Rd
Suite D720
Boynton Beach, FL 33437-3777
Phone (561) 402-3971

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025040376.FLMDPsychiatric/Mental Health Nurse Practitioner
APRN11041704.FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stedfast Medical Services LLC Single Specialty CurrentSince Nov 1, 2025 Accepting new patients

Locations

10301 Hagen Ranch Rd
Ste D720
Boynton Beach, FL 33437
Phone (561) 336-1890

3365 Burns Rd
Ste 203
Palm Beach Gardens, FL 33410
Phone (561) 412-9373

Organizations & group practices 1

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": "1755216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1639055437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9517 BOCA RIVER CIR FL 33434",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343955",
            "telephone_number": "561-609-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9517 BOCA RIVER CIR FL 33434",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343955",
            "telephone_number": "561-609-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUQUE",
        "first_name": "ANDRES",
        "middle_name": "MIGUEL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "2025040376.",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11041704.",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.