Individual provider Active NPI

Jeanine Tripp, ARNP

  • Family Nurse Practitioner
  • Daytona Beach, FL
National Provider Identifier
1700449238
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11000512 Issued in FL
Practice address
1630 Mason Ave Ste C
Daytona Beach, FL 32117
Phone
(386) 238-9064
Fax
(386) 238-9063
NPI assigned
Apr 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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 APRN11000512 FL Primary

Addresses

Primary practice location

1630 Mason Ave Ste C
Daytona Beach, FL 32117

Mailing address

1630 Mason Ave Ste C
Daytona Beach, FL 32117-4503
Phone (386) 238-9064

Other practice location 1

2355 Truman Scarborough Way
Titusville, FL 32796
Phone (407) 732-7957

Other practice location 2

2355 Truman Scarborough Way
Titusville, FL 32796
Phone (407) 732-7957

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
I20190508001672 FL Practitioner - Nurse Practitioner 0345582573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excellence Health LLCGroup PAC ID 0840534160, 49 clinicians

Practice addresses (Care Compare)

1630 Mason Ave
Suite C
Daytona Beach, FL 32117-4503
Phone (386) 238-9064

Hospital & facility affiliations

  • Halifax Health Hospice Hospice, Port Orange, FL, CCN 101522
  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014

Merit-based Incentive Payment System (MIPS)

Final score
93.99 of 100Reported as group
Quality
84.82
Promoting interoperability
100
Improvement activities
40
Cost
61.81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Excellence Health, LLC CurrentSince Jun 1, 2019 Accepting new patients

Locations

1630 Mason Ave
Ste C
Daytona Beach, FL 32117
Phone (386) 238-9064

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1700449238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 MASON AVE STE C",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174503",
            "telephone_number": "386-238-9064",
            "fax_number": "386-238-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MASON AVE STE C",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32117",
            "telephone_number": "386-238-9064",
            "fax_number": "386-238-9063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2355 Truman Scarborough Way",
            "address_purpose": "LOCATION",
            "city": "Titusville",
            "state": "FL",
            "postal_code": "32796",
            "country_code": "US",
            "telephone_number": "407-732-7957",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2355 Truman Scarborough Way",
            "address_purpose": "LOCATION",
            "city": "Titusville",
            "state": "FL",
            "postal_code": "32796",
            "country_code": "US",
            "telephone_number": "407-732-7957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRIPP",
        "first_name": "JEANINE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-19",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11000512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.