Mary Lou Koretsky, ARNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

ARNP3280292 Issued in FL

Practice address

2955 Pineda Plaza Way Ste 115
Melbourne, FL 32940-7306

Phone

(321) 254-7375

Fax

(321) 254-7145

NPI assigned

Nov 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Peter a Koretsky MD PA

  • Gastroenterology Physician
  • Melbourne, FL
  • NPI 1124117791
  NPD (past)

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289260800000",
    "number": "1891096731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 PINEDA PLAZA WAY STE 115",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407306",
            "telephone_number": "321-254-7375",
            "fax_number": "321-254-7145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 PINEDA PLAZA WAY STE 115",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407306",
            "telephone_number": "321-254-7375",
            "fax_number": "321-254-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORETSKY",
        "first_name": "MARY",
        "middle_name": "LOU",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP3280292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jo A Kologlu, PT
• Aleksander Richard Komar, MD
• Elaine M. Kondroski, M. D.
• Avanthi Kopuri, D.M.D., M.S.D.
• Nageswara Rao Kopuri, BDS.,MS.
• Peter A Koretsky, MD
• Lizamar S Korfhage, PA C
• Heather Marie Korkowski, APRN
• Sarah Kort
• Kory Casey, P.a.

• Adult Health Nurse Practitioner in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; 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.