Individual provider Active NPI

Lacy Michelle Kusy, ARNPC

  • Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1700249596
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP 9264855 Issued in FL
Practice address
1717 N E St Ste 422
Pensacola, FL 32501-6333
Phone
(850) 908-1220
Fax
(850) 908-1229
NPI assigned
Mar 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1180980 AL
Nurse Practitioner 363L00000X ARNP 9264855 FL Primary

Addresses

Primary practice location

1717 N E St Ste 422
Pensacola, FL 32501-6333

Mailing address

PO Box 17567
Pensacola, FL 32522-7567
Phone (850) 475-3600

Other identifiers 1

IdentifierTypeStateIssuer
017042500MedicaidFL

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
I20160714002499 FL Practitioner - Nurse Practitioner 1456643238 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.01 of 100Reported as group
Quality
62.34
Promoting interoperability
95
Improvement activities
40
Cost
78.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1180980ALMDNurse Practitioner
ARNP 9264855FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virta Medical P.C. CurrentSince May 31, 2025 Accepting new patients

Locations

501 Folsom St
Fl 1
San Francisco, CA 94105

1201 Hays St
Fl 1
Tallahassee, FL 32301

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": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1700249596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17567",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325227567",
            "telephone_number": "850-475-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 N E ST STE 422",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325016333",
            "telephone_number": "850-908-1220",
            "fax_number": "850-908-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSY",
        "first_name": "LACY",
        "middle_name": "MICHELLE",
        "credential": "ARNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1180980",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 9264855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017042500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.