Individual provider Active NPI

Lisy Mathew, ARNP

  • Family Nurse Practitioner
  • Vero Beach, FL
National Provider Identifier
1811474489
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11000419 Issued in FL
Practice address
2250 Indian Creek Blvd W
Vero Beach, FL 32966-1331
Phone
(772) 562-7400
NPI assigned
Jul 25, 2018
Last updated
May 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11000419 FL Primary

Addresses

Primary practice location

2250 Indian Creek Blvd W
Vero Beach, FL 32966-1331

Mailing address

2120 15TH St
Vero Beach, FL 32960-3174
Phone (772) 563-8315

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
I20190404000066 FL Practitioner - Nurse Practitioner 9830430628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2250 Indian Creek Blvd W
Vero Beach, FL 32966-1331
Phone (772) 562-7400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Acts Signature Community Services, Inc. Current Accepting new patients
Acts Retirement-Life Communities, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Acts Retirement-Life Communities, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Acts Signature Community Services, Inc. CurrentSince Jan 8, 2019 Accepting new patients
Acts Signature Community Services, Inc. CurrentSince Jan 8, 2019 Accepting new patients

Locations

2250 Indian Creek Blvd W
Vero Beach, FL 32966
Phone (772) 562-7400

420 Delaware Dr
Ft Washington, PA 19034
Phone (215) 661-8330

Interoperability endpoints

  • Direct secure messaging: lisy.mathew.p1@direct.actslife.nextgenshare.com

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.

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": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1811474489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 15TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603174",
            "telephone_number": "772-563-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 INDIAN CREEK BLVD W",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329661331",
            "telephone_number": "772-562-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "LISY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-25",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11000419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.