Individual provider Active NPI

Rachelle Hagan

  • Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1821686668
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN9410273 Issued in FL
Practice address
1301 W Eau Gallie Blvd Ste 108
Melbourne, FL 32935-5390
Phone
(321) 622-8730
NPI assigned
Jan 7, 2021
Last updated
Aug 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN9410273 FL Primary

Addresses

Primary practice location

1301 W Eau Gallie Blvd Ste 108
Melbourne, FL 32935-5390

Mailing address

PO Box 361095
Melbourne, FL 32936-1095
Phone (321) 253-2900

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
I20210323002304 FL Practitioner - Nurse Practitioner 6406263227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Brevard LLCGroup PAC ID 4486558012, 75 clinicians

Practice addresses (Care Compare)

1301 W Eau Gallie Blvd
Suite 108
Melbourne, FL 32935-5390
Phone (321) 622-8730

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9410273FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Brevard LLC CurrentSince Apr 8, 2025 Accepting new patients
Indian River Health Services Inc Past Accepting new patients

Locations

1301 W Eau Gallie Blvd
Ste 108
Melbourne, FL 32935
Phone (321) 622-8730

1305 Hickory St
Melbourne, FL 32901
Phone (321) 255-1500

Interoperability endpoints

  • Direct secure messaging: rachellehagan@mab.medentdirect.com

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, 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": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1821686668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361095",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329361095",
            "telephone_number": "321-253-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W EAU GALLIE BLVD STE 108",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355390",
            "telephone_number": "321-622-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "RACHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "RN9410273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.