Individual provider Active NPI

Andrea Claire Muggli, APRN

  • Family Medicine Physician
  • Port Saint Lucie, FL
National Provider Identifier
1861058745
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
APRN11000485 Issued in FL
Practice address
11380 SW Village Pkwy Ste 100
Port Saint Lucie, FL 34987-2389
Phone
(772) 301-6500
NPI assigned
May 15, 2019
Reactivated
Sep 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X APRN11000485 FL
Family Medicine Physician 207Q00000X APRN11000485 FL Primary

Addresses

Primary practice location

11380 SW Village Pkwy Ste 100
Port Saint Lucie, FL 34987-2389

Mailing address

11380 SW Village Pkwy Ste 100
Port Saint Lucie, FL 34987-2389
Phone (772) 301-6500

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
I20190823002032 FL Practitioner - Nurse Practitioner 6305174665 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11000485FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors House Calls of Florida, LLC Single Specialty CurrentSince May 29, 2019 Accepting new patients
Vitas Healthcare Corporation of Florida Single Specialty PastSince Jul 23, 2023 Accepting new patients

Locations

1239 SE Indian St
Ste 102
Stuart, FL 34997
Phone (561) 900-2497

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24095/brand/1/csg/1/fhir/r4

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": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1861058745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11380 SW VILLAGE PKWY STE 100",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872389",
            "telephone_number": "772-301-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11380 SW VILLAGE PKWY STE 100",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872389",
            "telephone_number": "772-301-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUGGLI",
        "first_name": "ANDREA",
        "middle_name": "CLAIRE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2023-09-12",
        "certification_date": "2023-07-18",
        "deactivation_date": "2023-09-06",
        "reactivation_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11000485",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "APRN11000485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.