Active NPI
Mary Chryssiadis, M.D.
- Pediatrics Physician
- Stuart, FL
National Provider Identifier
1730149725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME 69427
- Practice address
- 3441 SE Willoughby Blvd
Stuart, FL 34994-5060 - Phone
- (772) 597-3687
- Fax
- (772) 597-4604
- NPI assigned
- Mar 24, 2006
- Last updated
- Jul 13, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME 69427 | FL | Primary |
Addresses
Primary practice location
3441 SE Willoughby Blvd
Stuart, FL 34994-5060
Mailing address
PO Box 267
16401 SW Farms Road
Indiantown, FL 34956-0267
Phone (772) 597-3687
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME69427 | Other | FL | MEDICAL LICENSE |
| G54955 | Other | CA | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 69427 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Care Corporation | Past | Accepting new patients | |
| Martin Memorial Physician Corporation Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Cleveland Clinic Imaging
- Radiology Clinic/Center
- Port St Lucie, FL
- NPI 1558320556
-
- Multi-Specialty Clinic/Center
- Stuart, FL
- NPI 1578505228
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1730149725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 267",
"address_2": "16401 SW FARMS ROAD",
"city": "INDIANTOWN",
"state": "FL",
"postal_code": "349560267",
"telephone_number": "772-597-3687",
"fax_number": "772-597-4604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3441 SE WILLOUGHBY BLVD",
"city": "STUART",
"state": "FL",
"postal_code": "349945060",
"telephone_number": "772-597-3687",
"fax_number": "772-597-4604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRYSSIADIS",
"first_name": "MARY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-24",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME 69427",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "ME69427",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "G54955",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stuart, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.