Individual provider Active NPI

Genoveva De la Cruz Jara, APRN

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1972254266
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11016535 Issued in FL
Practice address
13681 Doctors Way
Fort Myers, FL 33912-4300
Phone
(239) 343-0623
Fax
(239) 343-0533
NPI assigned
Jan 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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 APRN11016535 FL Primary

Addresses

Primary practice location

13681 Doctors Way
Fort Myers, FL 33912-4300

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-0623

Other practice location 1

9470 Healthpark Cir
Fort Myers, FL 33908-3600
Phone (239) 482-4673

Other identifiers 1

IdentifierTypeStateIssuer
124984300MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gjara721171@Direct.leememorial.org Direct LEE HEALTH SYSTEM INC

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
I20241206002034 FL Practitioner - Nurse Practitioner 9537695010 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Hospice and Community Services, Inc CurrentSince Sep 23, 2024 Accepting new patients

Locations

301 S Gloria St
Clewiston, FL 33440
Phone (863) 938-5123

9470 Healthpark Cir
Fort Myers, FL 33908
Phone (239) 433-8073

16131 Roserush Ct
Fort Myers, FL 33908
Phone (239) 343-7300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1972254266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-0623",
            "fax_number": "239-343-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13681 DOCTORS WAY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124300",
            "telephone_number": "239-343-0623",
            "fax_number": "239-343-0533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9470 Healthpark Cir",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339083600",
            "country_code": "US",
            "telephone_number": "239-482-4673",
            "fax_number": "239-482-2659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARA",
        "first_name": "GENOVEVA",
        "middle_name": "DE LA CRUZ",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11016535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124984300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gjara721171@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "LEE HEALTH SYSTEM INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.