Individual provider Active NPI

Vanessa De Oliveira Inacio, M.D.

  • Family Medicine Physician
  • Coconut Creek, FL
National Provider Identifier
1790071066
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME120396 Issued in FL
Practice address
4828 Coconut Creek Parkway
Coconut Creek, FL 33063
Phone
(954) 971-2266
Fax
(877) 319-1851
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT200416 PA
Family Medicine Physician 207Q00000X ME120396 FL Primary

Addresses

Primary practice location

4828 Coconut Creek Parkway
Coconut Creek, FL 33063

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (305) 500-2000

Other identifiers 2

IdentifierTypeStateIssuer
14VJ8OtherFLBLUE CROSS BLUE SHIELD
012494700MedicaidFL

Other names 1

  • Vanessa De Oliveira Inacio Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vanessa.de.oliveira.inacio.1@29601.direct.athenahealth.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140909000888 FL Practitioner - Family Practice 7618115643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12901 Bruce B Downs Blvd
MDC 62
Tampa, FL 33612-4742

6101 Blue Lagoon Dr
Suite 400
Miami, FL 33126

6101 Blue Lagoon Dr
Suite 400
Miami, FL 33126-2051

Hospital & facility affiliations

  • Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME120396FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC Family Medicine CurrentSince Oct 25, 2021 Accepting new patients

Locations

4828 Coconut Creek Pkwy
Coconut Creek, FL 33063
Phone (954) 247-2168

1301 Lyons Rd
Coconut Creek, FL 33063
Phone (954) 971-2266

6221 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 491-1686

440 W 49th St
Hialeah, FL 33012
Phone (305) 828-5000

6101 Blue Lagoon Dr
Ste 400
Miami, FL 33126
Phone (305) 500-2114

4960 SW 72nd Ave
Ste 406
Miami, FL 33155

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

Organizations & group practices 1

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 1

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": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1790071066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "305-500-2000",
            "fax_number": "877-319-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4828 COCONUT CREEK PARKWAY",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "33063",
            "telephone_number": "954-971-2266",
            "fax_number": "877-319-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INACIO",
        "first_name": "VANESSA",
        "middle_name": "DE OLIVEIRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT200416",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME120396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "14VJ8",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012494700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vanessa.de.oliveira.inacio.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4828 Coconut Creek Parkway",
            "city": "Coconut Creek",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "DE OLIVEIRA INACIO",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Coconut Creek, FL

Sources for this page

Verify at the official NPI Registry.