Individual provider Active NPI

Sherise Melanie Stark, APRN

  • Family Nurse Practitioner
  • Sebastian, FL
National Provider Identifier
1669022505
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11004086 Issued in FL
Practice address
13505 US Highway 1
Sebastian, FL 32958-3759
Phone
(772) 257-8224
Fax
(772) 213-3157
NPI assigned
Sep 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11004086 FL Primary

Addresses

Primary practice location

13505 US Highway 1
Sebastian, FL 32958-3759

Mailing address

1555 Indian River Blvd Ste B210
Vero Beach, FL 32960-7113
Phone (772) 257-8224

Other identifiers 1

IdentifierTypeStateIssuer
APRN11004086OtherFLSTATE LICENSE

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
I20191029000082 FL Practitioner - Nurse Practitioner 5991037798 Reassigns benefits to 2 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

Practice addresses (Care Compare)

12196 County Rd
Suite 512
Fellsmere, FL 32948-5463
Phone (772) 257-8224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11004086FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Treasure Coast Community Health Inc CurrentSince Dec 22, 2020 Accepting new patients
MD Primary Care Inc CurrentSince Sep 4, 2019 Accepting new patients
Treasure Coast Community Health Inc CurrentSince Dec 22, 2020 Accepting new patients

Locations

12196 County Road 512
Fellsmere, FL 32948
Phone (561) 571-8828

2215 Nebraska Ave
Ste 2-B
Fort Pierce, FL 34950
Phone (772) 302-3767

13505 US Highway 1
Sebastian, FL 32958
Phone 7722578224 ext. 339

1400 27th St
Vero Beach, FL 32960

1545 9th St SW
Vero Beach, FL 32962
Phone 77225782241908

1553 US Highway 1
Vero Beach, FL 32960
Phone (772) 562-3234

1555 Indian River Blvd
Ste B210
Vero Beach, FL 32960

4675 28th Ct
Vero Beach, FL 32967
Phone (772) 770-5151

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BDGDCD

Organizations & group practices 3

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": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1669022505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 INDIAN RIVER BLVD STE B210",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607113",
            "telephone_number": "772-257-8224",
            "fax_number": "772-252-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13505 US HIGHWAY 1",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583759",
            "telephone_number": "772-257-8224",
            "fax_number": "772-213-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "SHERISE",
        "middle_name": "MELANIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11004086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "APRN11004086",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

Verify at the official NPI Registry.