MPP Infusion Center of Port St Lucie LLC

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

MPP INFUSION CENTER OF PORT ST LUCIE LLC

Practice address

525 NW Lake Whitney PL Ste 101
Port St Lucie, FL 34986-1605

Phone

(561) 323-8987

NPI assigned

Jul 3, 2019

Organization subpart

No

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

Authorized official

Name

Sue Ellen Rottura

Title

Chief Operating Officer

Phone

(561) 323-8987

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Blanca Monica Fernandez, NP-C

  • Family Nurse Practitioner
  • Oldsmar, FL
  • NPI 1538512504
  Medicare reassignment Care Compare group NPD
• Cherez Pouncey, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Orlando, FL
  • NPI 1407324700
  Medicare reassignment Care Compare group NPD
• Sharon Sims, APRN

  • Family Nurse Practitioner
  • Tampa, FL
  • NPI 1689299612
  Medicare reassignment Care Compare group NPD
• Leeann Dam, FNP-C

  • Family Nurse Practitioner
  • Dallas, TX
  • NPI 1275924169

  FL

  Medicare reassignment Care Compare group NPD
• Kathleen Britton, NP

  • Family Nurse Practitioner
  • Woburn, MA
  • NPI 1285318782

  FL

  Medicare reassignment NPD
• Wendy Roper, APRN, FNP-C

  • Family Nurse Practitioner
  • Frisco, TX
  • NPI 1689146011

  FL

  Medicare reassignment NPD
• Mia Boehler, NURSE PRACTITIONER

  • Acute Care Nurse Practitioner
  • Jamaica, NY
  • NPI 1730532482
  NPD

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1811559487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 COLE BLVD STE 250",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013262",
            "telephone_number": "720-465-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 NW LAKE WHITNEY PL STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861605",
            "telephone_number": "561-323-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MPP INFUSION CENTER OF PORT ST LUCIE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-03",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "ROTTURA",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "561-323-8987"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Moses, CRNA
• Joana L Moton, SLP
• Moving Forward Psychology Services (Dr. Dawna Bone, PsyD)
• Moving Into New Dimensions Therapeutic Services LLLC (M.I.N.D. Therapeutic Services LLC)
• Laura T Moylan, CLC
• Mrdical Clinics PA (The Wellness Center at Harbor Place)
• Paula Muller-Pena, MD
• Arnesa Mundell
• Brittany Munkres
• Jose Antonio Munoz

• Infusion Therapy Clinic/Center in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Infusion Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.