Individual provider Active NPI

Patrick Aquino Vergel de Dios, ARNP, FNP-C

  • Family Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1760993786
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9331457 Issued in FL
Practice address
1801 SE Hillmoor Dr Ste a-107
Port St Lucie, FL 34952-7545
Phone
(772) 446-0950
Fax
(772) 446-0956
NPI assigned
Oct 17, 2017
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X RN2338961 MA
Nurse Practitioner 363L00000X RN2338961 MA
Community Health Nurse Practitioner 363LC1500X RN2338961 MA
Family Nurse Practitioner 363LF0000X ARNP9331457 FL Primary

Addresses

Primary practice location

1801 SE Hillmoor Dr Ste a-107
Port St Lucie, FL 34952-7545

Mailing address

1801 SE Hillmoor Dr Ste a-107
Port St Lucie, FL 34952-7545
Phone (772) 446-0950

Other practice location 1

Holyoke Health Center, Inc
230 Maple St
Holyoke, MA 01040
Phone (413) 420-2200

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
I20171121001494 FL Practitioner - Nurse Practitioner 9931466216 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1801 SE Hillmoor Dr
Port St Lucie, FL 34952-7545
Phone (772) 446-0950

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9331457FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jupiter Medical Center Physicians Group Inc CurrentSince Aug 21, 2023 Accepting new patients
Jupiter Medical Center Physicians Group Inc Current Accepting new patients
Jupiter Medical Center Physicians Group CurrentSince Aug 21, 2023 Accepting new patients
Premium Primary Care & Walk-in Clinic Inc CurrentSince Feb 1, 2024 Accepting new patients
Holyoke Health Center Inc. Past Accepting new patients

Locations

1002 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 741-5695

5430 Military Trl
Ste 64
Jupiter, FL 33458
Phone (561) 263-7010

1801 SE Hillmoor Dr
Ste A-107
Port St Lucie, FL 34952
Phone (772) 335-3350

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFDDDD/Endpoint/CFDDDD

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1760993786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DR STE A-107",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527545",
            "telephone_number": "772-446-0950",
            "fax_number": "772-446-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DR STE A-107",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527545",
            "telephone_number": "772-446-0950",
            "fax_number": "772-446-0956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Holyoke Health Center, Inc",
            "address_2": "230 Maple St",
            "address_purpose": "LOCATION",
            "city": "Holyoke",
            "state": "MA",
            "postal_code": "01040",
            "country_code": "US",
            "telephone_number": "413-420-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERGEL DE DIOS",
        "first_name": "PATRICK",
        "middle_name": "AQUINO",
        "credential": "ARNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-17",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "RN2338961",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2338961",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "MA",
            "license": "RN2338961",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9331457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.