Individual provider Active NPI

Bridget Peurach, AGNP-C, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • East Palatka, FL
National Provider Identifier
1780298562
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11035825 Issued in FL
Practice address
215 S US Highway 17
East Palatka, FL 32131-4087
Phone
(386) 232-9203
Fax
(386) 222-3064
NPI assigned
Aug 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LG0600X APRN11035825 FL Primary

Addresses

Primary practice location

215 S US Highway 17
East Palatka, FL 32131-4087

Mailing address

209 Pinehurst Pointe Dr
St Augustine, FL 32092-3703
Phone (386) 232-9203

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bthoma44@emich.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221116001798 OH Practitioner - Nurse Practitioner 1153799598
I20250128002699 FL Practitioner - Nurse Practitioner 1153799598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ansaarie Cardiac and Endovascular Center of ExcellenceGroup PAC ID 8123309127, 5 clinicians

Practice addresses (Care Compare)

215 S US Hwy 17
East Palatka, FL 32131-4087
Phone (386) 232-9203

Hospital & facility affiliations

  • HCA Florida Putnam Hospital Hospital, Palatka, FL, CCN 100232
  • Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Endovascular Institute Single Specialty CurrentSince Jan 1, 2025 Accepting new patients
Ansaarie Cardiac & Endovascular Center of Excellence Single Specialty CurrentSince Jan 1, 2025 Accepting new patients

Locations

215 S US Highway 17
East Palatka, FL 32131
Phone (386) 232-9203

1301 Plantation Island Dr S
Ste 401A
Saint Augustine, FL 32080
Phone (386) 232-9203

Interoperability endpoints

  • Direct secure messaging: bpeurach755277@direct.shands.ufl.edu
  • FHIR API: https://fhir4.healow.com/fhir/r4/CGGIAD

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 3

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": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1780298562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 PINEHURST POINTE DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923703",
            "telephone_number": "386-232-9203",
            "fax_number": "386-222-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S US HIGHWAY 17",
            "city": "EAST PALATKA",
            "state": "FL",
            "postal_code": "321314087",
            "telephone_number": "386-232-9203",
            "fax_number": "386-222-3064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEURACH",
        "first_name": "BRIDGET",
        "credential": "AGNP-C, AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11035825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bthoma44@emich.edu",
            "affiliation": "N",
            "address_1": "6051 Alexa Ln",
            "city": "Sylvania",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435603607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Palatka, FL

Sources for this page

Verify at the official NPI Registry.