Individual provider Active NPI

Manushka Noelus, MSN, APRN, FNP - C

  • Family Nurse Practitioner
  • Davenport, FL
National Provider Identifier
1841893963
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11010115 Issued in FL
Practice address
7575 Osceola Polk Line Rd
Davenport, FL 33896-9112
Phone
(321) 677-0531
NPI assigned
Nov 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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 11010115 FL Primary

Addresses

Primary practice location

7575 Osceola Polk Line Rd
Davenport, FL 33896-9112

Mailing address

7575 Osceola Polk Line Rd
Davenport, FL 33896-9112
Phone (561) 598-3550

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
I20240606002868 FL Practitioner - Nurse Practitioner 1153863048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians
Pcma Palliative Division LLCGroup PAC ID 1456613637, 72 clinicians

Practice addresses (Care Compare)

1 CVS Dr
Woonsocket, RI 02895-6146

1 CVS Drive- MC
Suite 3040
Woonsocket, RI 02895-6146

121 W Macclenny Ave
Macclenny, FL 32063-2029
Phone (866) 389-2727

1800 E Hwy 50
Clermont, FL 34711-1914
Phone (866) 389-2727

4833 Fruitville Rd
Unit 101
Sarasota, FL 34232-1885
Phone (878) 201-3312

7575 Osceola Polk Line Rd
Davenport, FL 33896-9112
Phone (866) 389-2727

7599 W Sand Lake Rd
Orlando, FL 32819-5109
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11010115FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince May 2, 2024 Accepting new patients

Locations

7575 Osceola Polk Line Rd
Davenport, FL 33896
Phone (321) 677-0531

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1841893963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7575 OSCEOLA POLK LINE RD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338969112",
            "telephone_number": "561-598-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 OSCEOLA POLK LINE RD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338969112",
            "telephone_number": "321-677-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOELUS",
        "first_name": "MANUSHKA",
        "credential": "MSN, APRN, FNP - C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11010115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.