Individual provider Active NPI

Edward J Judge, APRN

  • Family Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1891450045
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11016242 Issued in FL
Practice address
1408 Stewart Blvd
Clearwater, FL 33764-2809
Phone
(727) 709-2512
NPI assigned
Nov 2, 2021
Last updated
Dec 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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 11016242 FL Primary

Addresses

Primary practice location

1408 Stewart Blvd
Clearwater, FL 33764-2809

Mailing address

1408 Stewart Blvd
Clearwater, FL 33764-2809
Phone (727) 709-2512

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
I20220316003816 FL Practitioner - Nurse Practitioner 7719372465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mana Health Partners PAGroup PAC ID 3971952813, 102 clinicians

Practice addresses (Care Compare)

1980 Sunset Point Rd
Clearwater, FL 33765-1132
Phone (732) 719-5039

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11016242FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mana Health Partners PA CurrentSince Oct 1, 2024 Accepting new patients

Locations

991 Pondella Rd
North Ft Myers, FL 33903
Phone (239) 994-8809

1507 S Tuttle Ave
Sarasota, FL 34239
Phone (941) 366-0336

338 Whitesville Rd
Ste 103
Jackson, NJ 08527

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": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1891450045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 STEWART BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337642809",
            "telephone_number": "727-709-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 STEWART BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337642809",
            "telephone_number": "727-709-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDGE",
        "first_name": "EDWARD",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11016242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.