Individual provider Active NPI

Kelly Marie McCaleb, FNP-BC

  • Family Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1912424136
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11008449 Issued in FL
Practice address
5545 N Wickham Rd Ste 104
Melbourne, FL 32940-7323
Phone
(321) 784-8211
Fax
(321) 394-9425
NPI assigned
Aug 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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 APRN11008449 FL Primary

Addresses

Primary practice location

5545 N Wickham Rd Ste 104
Melbourne, FL 32940-7323

Mailing address

5545 N Wickham Rd Ste 104
Melbourne, FL 32940-7323
Phone (321) 784-8211

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
I20201012000033 FL Practitioner - Nurse Practitioner 6901167964 Reassigns benefits to 1 organization

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
Tampa Pain Relief Center IncGroup PAC ID 6002715158, 33 clinicians

Practice addresses (Care Compare)

5545 N Wickham Rd
Suite 104
Melbourne, FL 32940-7323
Phone (321) 784-8211

Hospital & facility affiliations

  • Pinnacle Home Care Home health agency, Orlando, FL, CCN 103127
  • Parrish Medical Center Hospital, Titusville, FL, CCN 100028
  • Viera Hospital Hospital, Melbourne, FL, CCN 100315
  • Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177
  • Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019

Merit-based Incentive Payment System (MIPS)

Final score
84.72 of 100Reported as group
Promoting interoperability
78
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11008449FLMDFamily Nurse Practitioner

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Tampa Pain Relief Center, Inc. CurrentSince May 1, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

325 Waymont Ct
Ste 111
Lake Mary, FL 32746
Phone (407) 585-0263

5545 N Wickham Rd
Ste 104
Melbourne, FL 32940
Phone (321) 784-8211

595 N Courtenay Pkwy
Ste 101
Merritt Island, FL 32953
Phone (321) 784-8211

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kelly.mccaleb.p2@direct.painreliefcenters.nextgenshare.com

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1912424136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5545 N WICKHAM RD STE 104",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407323",
            "telephone_number": "321-784-8211",
            "fax_number": "321-394-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5545 N WICKHAM RD STE 104",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407323",
            "telephone_number": "321-784-8211",
            "fax_number": "321-394-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALEB",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.