Individual provider Active NPI

Peter Casimir Ciechanowski, APRN

  • Family Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1982309795
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11025562 Issued in FL
Practice address
1900 S Harbor City Blvd Ste 225
Melbourne, FL 32901-4789
Phone
(321) 216-2288
NPI assigned
Apr 3, 2023
Last updated
Apr 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 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 APRN11025562 FL Primary

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

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
I20230509002403 FL Practitioner - Nurse Practitioner 4082070495 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medfast Urgent Care Centers LLCGroup PAC ID 1052418837, 73 clinicians
A Kut Above Mobile Medical IncGroup PAC ID 3779921929, 4 clinicians
Practitioners in Motion PLLCGroup PAC ID 9335456755, 9 clinicians

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11025562FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
A Kut Above Mobile Medical Inc CurrentSince Feb 1, 2024 Accepting new patients
Medfast Urgent Care Centers LLC CurrentSince Jul 1, 2025 Accepting new patients
Medfast Urgent Care Centers, LLC CurrentSince Jul 1, 2025 Accepting new patients
Practitioners in Motion PLLC CurrentSince Apr 1, 2023 Accepting new patients

Locations

1785 Waverly Pl
Ste A
Melbourne, FL 32901
Phone (321) 216-2288

1900 S Harbor City Blvd
Ste 225
Melbourne, FL 32901
Phone (321) 216-2288

1900 S Harbor City Blvd
Ste 232
Melbourne, FL 32901
Phone (321) 216-2288

7970 N Wickham Rd
Melbourne, FL 32940
Phone (321) 255-7711

5005 Port St John Pkwy
Port St John, FL 32927
Phone (321) 504-0556

Networks

  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1982309795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13850 83RD ST",
            "city": "FELLSMERE",
            "state": "FL",
            "postal_code": "329486267",
            "telephone_number": "412-758-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S HARBOR CITY BLVD STE 225",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329014789",
            "telephone_number": "321-216-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIECHANOWSKI",
        "first_name": "PETER",
        "middle_name": "CASIMIR",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11025562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.