Individual provider Active NPI

Stephanie Declue Cesarec, ARNP-C

  • Family Nurse Practitioner
  • Summerfield, FL
National Provider Identifier
1902331192
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9186748 Issued in FL
Practice address
17820 SE 109TH Ave
Suite 108
Summerfield, FL 34491-8968
Phone
(352) 693-2340
Fax
(352) 693-2345
NPI assigned
Apr 25, 2017
Last updated
Apr 25, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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 ARNP9186748 FL Primary

Addresses

Primary practice location

17820 SE 109TH Ave
Suite 108
Summerfield, FL 34491-8968

Mailing address

4622 County Road 103G
Oxford, FL 34484-2926
Phone (352) 427-3966

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
I20181012000592 FL Practitioner - Nurse Practitioner 9739431107 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vizavee Urgent and Primary Care, LLCGroup PAC ID 1557764784, 15 clinicians

Practice addresses (Care Compare)

4669 E Sr
44 Suite 101
Wildwood, FL 34785-7460
Phone (352) 399-7301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9186748FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Sheridan Emergency Physician Services Inc CurrentSince May 18, 2020 Accepting new patients
Sheridan Emergency Physician Services, Inc CurrentSince May 18, 2020 Accepting new patients
Sheridan Emergency Physician Services Inc Current Accepting new patients
Vizavee Urgent & Primary Care, LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

1210 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 743-5073

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

4600 SW 46th Ct
Ocala, FL 34474
Phone (352) 291-3000

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

5731 Bee Ridge Rd
Sarasota, FL 34233
Phone (888) 221-2216

4669 E State Road 44
Ste 101
Wildwood, FL 34785
Phone (352) 399-7301

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24264/brand/1/csg/1/fhir/r4
  • Direct secure messaging: stephanie.cesarec.1@24264.direct.athenahealth.com

Organizations & group practices 5

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": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1902331192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4622 COUNTY ROAD 103G",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344842926",
            "telephone_number": "352-427-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17820 SE 109TH AVE",
            "address_2": "SUITE 108",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918968",
            "telephone_number": "352-693-2340",
            "fax_number": "352-693-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CESAREC",
        "first_name": "STEPHANIE",
        "middle_name": "DECLUE",
        "name_prefix": "Mrs.",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9186748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerfield, FL

Sources for this page

Verify at the official NPI Registry.