Peter Casimir Ciechanowski, APRN
Individual provider Active NPI Family Nurse Practitioner · Melbourne, FL
NPI 1982309795 · NPPES record last updated Apr 3, 2023
Key facts
- NPI
- 1982309795
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN11025562 (FL)
- Practice address
- 1900 S Harbor City Blvd Ste 225
Melbourne, FL 32901-4789 - Phone
- (321) 216-2288
- NPI assigned
- Apr 3, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Medfast Urgent Care Centers LLC
A Kut Above Mobile Medical Inc
Practitioners in Motion PLLC
Practice addresses (Care Compare)
1400 Rockledge Blvd
Rockledge, FL 32955-2846
Phone (321) 735-8960
1785 Waverly PL
Suite a
Melbourne, FL 32901-4641
Phone (321) 216-2288
1900 S Harbor Blvd
Suite 232
Melbourne, FL 32901-3805
Phone (321) 216-2288
206 E New Haven Ave
Melbourne, FL 32901-4504
Phone (321) 802-3311
2500 Minton Rd
West Melbourne, FL 32904-6602
Phone (321) 633-3278
390 N Courtenay Pkwy
Merritt Island, FL 32953-3456
Phone (321) 633-3162
490 Ctr Lake Dr NE
Suite 200
Palm Bay, FL 32907-1113
Phone (321) 751-7222
5005 Port St John Pkwy
Port St John, FL 32927-4305
Phone (321) 757-7222
820 Palm Bay Rd NE
Suite 110
Palm Bay, FL 32905-6351
Phone (321) 633-3278
Hospital & facility affiliations
- HCA Florida Healthcare at Home
- HCA Florida Healthcare at Home
- NHC Homecare
- Trilogy Home Healthcare
- NHC Homecare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230509002403 | FL | Practitioner - Nurse Practitioner | 4082070495 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11025562 | FL | MD | Family Nurse Practitioner |
Practice roles (4 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medfast Urgent Care Centers LLC | Current |
Accepting new patients | |
| Practitioners in Motion PLLC | Current |
Accepting new patients | |
| A Kut Above Mobile Medical Inc | Current |
Accepting new patients | |
| Medfast Urgent Care Centers, LLC | Current |
Accepting new patients |
Locations
1900 S Harbor City Blvd
Ste 225
Melbourne, FL 32901
Phone (321) 216-2288
7970 N Wickham Rd
Melbourne, FL 32940
Phone (321) 255-7711
1785 Waverly Pl
Ste A
Melbourne, FL 32901
Phone (321) 216-2288
1900 S Harbor City Blvd
Ste 232
Melbourne, FL 32901
Phone (321) 216-2288
5005 Port St John Pkwy
Port St John, FL 32927
Phone (321) 504-0556
Networks
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11025562 | FL | Yes |
Addresses
Primary practice location
1900 S Harbor City Blvd Ste 225
Melbourne, FL 32901-4789
Mailing address
13850 83Rd St
Fellsmere, FL 32948-6267
Phone (412) 758-1035
Other providers in Melbourne, FL
- Kristi L Christman
- Christopher J Prusinski DO PA
- Blake Churchman
- Santy A Ciar
- Ciara Forde PT, DPT, CSCS PLLC
- Krzysztof Cieslik
- Joseph A Cimino
- Linette Cintron-Medina
- Circles of Care
- Circles of Care Inc
All providers in Melbourne, FL · Family Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.