Individual provider Active NPI

Susan E Bravo, ARNP

  • Nurse Practitioner
  • Stuart, FL
National Provider Identifier
1679592273
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN1949502 Issued in FL
Practice address
2150 SE Salerno Rd
Stuart, FL 34997-6572
Phone
(772) 223-5777
Fax
(772) 223-5751
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN1949502 FL Primary

Addresses

Primary practice location

2150 SE Salerno Rd
Stuart, FL 34997-6572

Mailing address

PO Box 417
Stuart, FL 34995-0417
Phone (772) 223-5665

Other identifiers 1

IdentifierTypeStateIssuer
301245000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sbravo4686@direct.martinhealth.org

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
I20100608000323 FL Practitioner - Nurse Practitioner 9133259708 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1949502FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Martin Memorial Medical Center Inc Current Accepting new patients

Locations

3496 NW Federal Hwy
Ste A
Jensen Beach, FL 34957
Phone (772) 223-5612

2150 SE Salerno Rd
Ste 200
Stuart, FL 34997
Phone (772) 223-5757

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

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Interoperability endpoints

  • Direct secure messaging: sbravo2496270@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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1679592273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349950417",
            "telephone_number": "772-223-5665",
            "fax_number": "772-223-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 SE SALERNO RD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349976572",
            "telephone_number": "772-223-5777",
            "fax_number": "772-223-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "RN1949502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301245000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbravo4686@direct.martinhealth.org",
            "affiliation": "N",
            "address_1": "2150 SE Salerno Rd",
            "city": "Stuart",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349976572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.