Individual provider Active NPI

Noel Eileen Medeiros, CRNP

  • Nurse Practitioner
  • Delray Beach, FL
National Provider Identifier
1841350485
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11005757 Issued in FL
Practice address
5352 Linton Blvd Ste 100
Delray Beach, FL 33484-6514
Phone
(561) 638-9140
Fax
(561) 404-5035
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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 APRN11005757 FL
Acute Care Nurse Practitioner 363LA2100X SP009271 PA
Nurse Practitioner 363L00000X APRN11005757 FL Primary

Addresses

Primary practice location

5352 Linton Blvd Ste 100
Delray Beach, FL 33484-6514

Mailing address

1 Federal St Ste Sw200
Camden, NJ 08103-1155
Phone (856) 356-4924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11005757FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
David S. Poll, M.D., PC Past Accepting new patients

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1841350485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE SW200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031155",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5352 LINTON BLVD STE 100",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846514",
            "telephone_number": "561-638-9140",
            "fax_number": "561-404-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEIROS",
        "first_name": "NOEL",
        "middle_name": "EILEEN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11005757",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP009271",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11005757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.