Individual provider Active NPI

Yvette Wirta-Clarke, DO

  • Emergency Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1962456426
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS8390 Issued in FL
Practice address
1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521
Phone
(772) 398-3800
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS8390 FL Primary

Addresses

Primary practice location

1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521

Mailing address

100 SW Atlanta Ave
Stuart, FL 34994-2009

Other identifiers 1

IdentifierTypeStateIssuer
05149OtherFLBCBS

Other names 1

  • Yvette Wirta Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS8390FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Turtle Run Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Gulfstream Emergency Physicians Emergency Medicine Past Accepting new patients
Sailfish ER SVCS Partnership LLC Emergency Medicine Past Accepting new patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962456426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SW ATLANTA AVE",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SE TIFFANY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527521",
            "telephone_number": "772-398-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTA-CLARKE",
        "first_name": "YVETTE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS8390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05149",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YVETTE",
            "last_name": "WIRTA",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.