Individual provider Active NPI

Meghan Marie Cequerella, NP

  • Gerontology Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1720790017
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11022296 Issued in FL
Practice address
3264 Greenwald Way N
Kissimmee, FL 34741-0728
Phone
(407) 539-0312
NPI assigned
Dec 19, 2022
Last updated
Sep 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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 APRN11022296 FL
Gerontology Nurse Practitioner 363LG0600X APRN11022296 FL Primary

Addresses

Primary practice location

3264 Greenwald Way N
Kissimmee, FL 34741-0728

Mailing address

3264 Greenwald Way N
Kissimmee, FL 34741-0728
Phone (407) 539-0312

Other practice location 1

2228 S Kirkman Rd
Orlando, FL 32811-2308
Phone (407) 615-8180

Other identifiers 1

IdentifierTypeStateIssuer
116737700MedicaidFL

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
I20230126000600 FL Practitioner - Nurse Practitioner 1850762030 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

3264 Greenwald Way N
Kissimmee, FL 34741-0728
Phone (407) 539-0312

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Feb 11, 2023 Accepting new patients
Adventhealth Primary Care Network Inc CurrentSince Nov 18, 2024 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Feb 11, 2023 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

7540 W University Ave
Gainesville, FL 32607
Phone (352) 265-0335

3264 Greenwald Way N
Kissimmee, FL 34741
Phone (407) 539-0312

Interoperability endpoints

  • Direct secure messaging: mcequerella3692197@adventhealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1720790017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 GREENWALD WAY N",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347410728",
            "telephone_number": "407-539-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 GREENWALD WAY N",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347410728",
            "telephone_number": "407-539-0312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2228 S Kirkman Rd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328112308",
            "country_code": "US",
            "telephone_number": "407-615-8180",
            "fax_number": "407-615-8182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEQUERELLA",
        "first_name": "MEGHAN",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11022296",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11022296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116737700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.