Individual provider Active NPI

Kristen Hanrahan, DO

  • Emergency Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1639506694
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
UO3437 Issued in FL
Practice address
1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521
Phone
(772) 398-1990
NPI assigned
Oct 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X UO3437 FL Primary

Addresses

Primary practice location

1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521

Mailing address

333 NW Somerset Cir
Port St Lucie, FL 34983-3435

Other names 1

  • Kristen Minton 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170629002523 FL Practitioner - Emergency Medicine 3678842994 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
UO3437FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1639506694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 NW SOMERSET CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349833435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SE TIFFANY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527521",
            "telephone_number": "772-398-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANRAHAN",
        "first_name": "KRISTEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "UO3437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "MINTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.