Individual provider Active NPI

Ann Marie Gonera, F.N.P.

  • Family Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1811198674
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11023607 Issued in FL
Practice address
10198 SW Village Pkwy Ste 105
Port St Lucie, FL 34987-2592
Phone
(772) 934-4990
Fax
(772) 934-4991
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 331208 NY
Family Nurse Practitioner 363LF0000X 331208 NY
Family Nurse Practitioner 363LF0000X APRN11023607 FL Primary

Addresses

Primary practice location

10198 SW Village Pkwy Ste 105
Port St Lucie, FL 34987-2592

Mailing address

177 Fort Washington Ave.
Milstein Hospital 8HS
New York, NY 10032
Phone (212) 305-4686

Other practice location 1

177 Fort Washington Ave.
Milstein Hospital 8HS
New York, NY 10032
Phone (212) 305-4686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20131001000217 NY Order and Referring Only - Nurse Practitioner 2365676566

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
331208NYMDLicensed Practical Nurse
APRN11023607FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tradition Health and Wellness Clinic PLLC CurrentSince Mar 12, 2024 Accepting new patients

Locations

10198 SW Village Pkwy
Ste 105
Port St Lucie, FL 34987
Phone (772) 934-4990

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.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1811198674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE.",
            "address_2": "MILSTEIN HOSPITAL 8HS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "212-305-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10198 SW VILLAGE PKWY STE 105",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872592",
            "telephone_number": "772-934-4990",
            "fax_number": "772-934-4991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "177 Fort Washington Ave.",
            "address_2": "Milstein Hospital 8HS",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10032",
            "country_code": "US",
            "telephone_number": "212-305-4686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONERA",
        "first_name": "ANN MARIE",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "331208",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "331208",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11023607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.