Sue Masiello Brock, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP 915972 Issued in FL

Practice address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Phone

(866) 686-2504

NPI assigned

May 28, 2010

Last updated

Sep 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1750600854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17920 GULF BLVD APT 101",
            "city": "REDINGTON SHORES",
            "state": "FL",
            "postal_code": "337081194",
            "telephone_number": "813-546-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "866-686-2504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6095 Marshalee Dr",
            "address_purpose": "LOCATION",
            "city": "Elkridge",
            "state": "MD",
            "postal_code": "210756053",
            "country_code": "US",
            "telephone_number": "866-686-2504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13000 Bruce B. Downs Blvd",
            "address_2": "MC 117 B",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "33612",
            "country_code": "US",
            "telephone_number": "813-972-2000 x5169",
            "fax_number": "813-972-7607",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17920 Gulf Blvd Apt 1010",
            "address_purpose": "LOCATION",
            "city": "Redington Shores",
            "state": "FL",
            "postal_code": "337081152",
            "country_code": "US",
            "telephone_number": "813-244-9478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCK",
        "first_name": "SUE",
        "middle_name": "MASIELLO",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-28",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 915972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.