Individual provider Active NPI

Lisette Vanessa Winans, APRN

  • Family Nurse Practitioner
  • Palm Bay, FL
National Provider Identifier
1821897398
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11039647 Issued in FL
Practice address
1051 Port Malabar Blvd NE Ste 4
Palm Bay, FL 32905-5153
Phone
(321) 844-7001
Fax
(321) 622-6544
NPI assigned
Mar 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN9332416 FL
Family Nurse Practitioner 363LF0000X APRN11039647 FL Primary

Addresses

Primary practice location

1051 Port Malabar Blvd NE Ste 4
Palm Bay, FL 32905-5153

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
I20250602000832 FL Practitioner - Nurse Practitioner 7113436262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Brevard LLCGroup PAC ID 4486558012, 75 clinicians

Practice addresses (Care Compare)

1051 Port Malabar Blvd NE
Suite 4
Palm Bay, FL 32905-5153
Phone (321) 844-7001

Hospital & facility affiliations

  • Pinnacle Home Care Home health agency, Orlando, FL, CCN 103127
  • Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
  • Palm Bay Hospital Hospital, Palm Bay, FL, CCN 100316

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9332416FLMDCritical Care Medicine Registered Nurse
APRN11039647FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Brevard LLC CurrentSince May 20, 2025 Accepting new patients

Locations

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

1051 Port Malabar Blvd NE
Ste 4
Palm Bay, FL 32905
Phone (321) 725-3438

Interoperability endpoints

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

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 4

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": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1821897398",
    "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": "1051 PORT MALABAR BLVD NE STE 4",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329055153",
            "telephone_number": "321-844-7001",
            "fax_number": "321-622-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINANS",
        "first_name": "LISETTE",
        "middle_name": "VANESSA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "RN9332416",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11039647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.