Individual provider Active NPI

Tyler Justin Smith, DNP, FNP-BC

  • Family Nurse Practitioner
  • Port Saint Lucie, FL
National Provider Identifier
1750113783
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11035424 Issued in FL
Practice address
1801 SE Hillmoor Dr Ste C-207
Port Saint Lucie, FL 34952-7574
Phone
(772) 335-4234
Fax
(772) 335-4236
NPI assigned
Aug 19, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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 APRN11035424 FL Primary

Addresses

Primary practice location

1801 SE Hillmoor Dr Ste C-207
Port Saint Lucie, FL 34952-7574

Mailing address

1801 SE Hillmoor Dr Ste C-207
Port Saint Lucie, FL 34952-7574
Phone (772) 335-4234

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
I20251119002012 FL Practitioner - Nurse Practitioner 8921599788 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Infectious DiseasesGroup PAC ID 4486689957, 18 clinicians

Practice addresses (Care Compare)

1801 SE Hillmoor Dr
Suite C 207
Port St Lucie, FL 34952-7574
Phone (772) 335-4234

356 E Midway Rd
Fort Pierce, FL 34982-7148
Phone (772) 464-9746

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11035424FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Infectious Diseases CurrentSince Aug 22, 2025 Accepting new patients
Midway Specialty Care Center Inc CurrentSince Aug 22, 2025 Accepting new patients

Locations

356 E Midway Rd
Fort Pierce, FL 34982
Phone (772) 464-9746

1801 SE Hillmoor Dr
Ste C-207
Port St Lucie, FL 34952
Phone (772) 335-4234

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.

Hospital & facility affiliations 4

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": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1750113783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DR STE C-207",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527574",
            "telephone_number": "772-335-4234",
            "fax_number": "772-335-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DR STE C-207",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527574",
            "telephone_number": "772-335-4234",
            "fax_number": "772-335-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TYLER",
        "middle_name": "JUSTIN",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-19",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11035424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.