Jacqueline Elizabeth Nurse, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP2784612 Issued in FL

Practice address

652 Canyon Stone Cir
Lake Mary, FL 32746-3978

Phone

(772) 333-4298

NPI assigned

Apr 1, 2017

Last updated

Apr 1, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Joseph J Katta MD PAGroup PAC ID 0244311553, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044
• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Merit-based Incentive Payment System (MIPS)

Final score

87.01 of 100Reported as group

Quality

81.53

Improvement activities

40

Cost

77.31

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Joseph J Katta MD PA

  • Gastroenterology Physician
  • Fort Pierce, FL
  • NPI 1427090224
  Medicare reassignment Care Compare group NPD
• Episource LLC

  • Nurse Practitioner
  • Gardena, CA
  • NPI 1225390289

  FL

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Martin Memorial Medical Center Inc

  dba Cleveland Clinic Martin North, South, Tradition Hospitals

  • General Acute Care Hospital
  • Stuart, FL
  • NPI 1194790055
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1491004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491004800000",
    "number": "1689106254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 CANYON STONE CIR",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463978",
            "telephone_number": "772-333-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 CANYON STONE CIR",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463978",
            "telephone_number": "772-333-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NURSE",
        "first_name": "JACQUELINE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-01",
        "last_updated": "2017-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2784612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Robert W O'Brien, MA CMHC
• Adam J O'Connor

• Nurse Practitioner in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.