Individual provider Active NPI

Tracy Ann Depaola, ARNP

  • Family Nurse Practitioner
  • Stuart, FL
National Provider Identifier
1861780207
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
PENDING Issued in FL
Practice address
501 SE Osceola St
Suite 301
Stuart, FL 34994-2301
Phone
(772) 223-5955
NPI assigned
Jul 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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 PENDING FL Primary

Addresses

Primary practice location

501 SE Osceola St
Suite 301
Stuart, FL 34994-2301

Mailing address

501 SE Osceola St
Ste 301
Stuart, FL 34994-2347
Phone (772) 878-7308

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
I20111027000262 FL Practitioner - Nurse Practitioner 2466625009 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGFLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stuart Oncology Associates, PA CurrentSince Jul 25, 2011 Accepting new patients

Locations

433 SE Ocean Blvd
Stuart, FL 34994
Phone (772) 223-4504

501 SE Osceola St
Ste 301
Stuart, FL 34994
Phone (772) 223-5955

448 SE Osceola St
Stuart, FL 34994
Phone (772) 221-3330

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1861780207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SE OSCEOLA ST",
            "address_2": "STE 301",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942347",
            "telephone_number": "772-878-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SE OSCEOLA ST",
            "address_2": "SUITE 301",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942301",
            "telephone_number": "772-223-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPAOLA",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.