Blue Ocean Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

BLUE OCEAN DERMATOLOGY LLC

Practice address

3951 S Nova Rd
Suite 3
Port Orange, FL 32127

Phone

(386) 256-1444

NPI assigned

Feb 22, 2013

Organization subpart

No

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

Authorized official

Name

Nitra H WelchNPI 1821141714

Title

Cfo

Phone

(386) 256-1444

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Blue Ocean Deramtology LLC

  • Dermatology Physician
  • Sebring, FL
  • NPI 1942183132
  NPPES parent name
• Blue Ocean Dermatology LLC

  • Dermatology Physician
  • Okeechobee, FL
  • NPI 1316820509
  NPPES parent name

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nitra Hobbs Welch, ARNP

  • Nurse Practitioner
  • Port Orange, FL
  • NPI 1821141714
  Medicare reassignment Care Compare group NPD Authorized official
• Sara Rebecca Corwin, FNP-C

  • Family Nurse Practitioner
  • Port Orange, FL
  • NPI 1245080332
  Medicare reassignment Care Compare group NPD
• Selena Crandall, ARNP

  • Family Nurse Practitioner
  • Ruskin, FL
  • NPI 1043635675
  Medicare reassignment Care Compare group NPD
• Jeffrey Stanton Demercurio, MD

  • Plastic Surgery Physician
  • Daytona Beach, FL
  • NPI 1174678908
  Medicare reassignment Care Compare group NPD
• Tiffany Everts, PA

  • Medical Physician Assistant
  • Port Orange, FL
  • NPI 1376492645
  Medicare reassignment Care Compare group NPD
• Paul Dudley Giles, M.D.

  • Plastic Surgery Physician
  • Stuart, FL
  • NPI 1164496360
  Medicare reassignment Care Compare group NPD
• Michael Alan McGriff, M.D.

  • Dermatology Physician
  • Summerfield, FL
  • NPI 1952337966
  Medicare reassignment Care Compare group NPD
• Christina Lee Morales, APRN

  • Family Nurse Practitioner
  • Fort Myers, FL
  • NPI 1285295139
  Medicare reassignment Care Compare group NPD
• Mark K Nagrani

  • Internal Medicine Physician
  • New Smyrna Beach, FL
  • NPI 1881154524
  Medicare reassignment Care Compare group NPD
• Nicole Nagrani, MD

  • Dermatology Physician
  • New Smyrna Beach, FL
  • NPI 1811457419
  Medicare reassignment Care Compare group NPD
• McKenzie Vanheusen, MSN, APRN

  • Nurse Practitioner
  • Tampa, FL
  • NPI 1144906744
  Medicare reassignment Care Compare group NPD
• Jason L Welch, NP

  • Nurse Practitioner
  • Port Orange, FL
  • NPI 1396791109
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1361491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1992045272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3951 S NOVA RD",
            "address_2": "SUITE 3",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279270",
            "telephone_number": "386-256-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3951 S NOVA RD",
            "address_2": "SUITE 3",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "32127",
            "telephone_number": "386-256-1444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1004 N Parrott Ave",
            "address_purpose": "LOCATION",
            "city": "Okeechobee",
            "state": "FL",
            "postal_code": "349722110",
            "country_code": "US",
            "telephone_number": "863-226-5466",
            "fax_number": "321-400-1118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1840 Greenwich Ave",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327894012",
            "country_code": "US",
            "telephone_number": "407-644-4212",
            "fax_number": "321-400-1118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUE OCEAN DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-22",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "NITRA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "386-256-1444"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008597300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Blanding
• Stephanie Blanton
• Lindsay Blaum, AGPCNP
• Bloom Behavioral Health LLC
• Willis Blower, LCSW
• Kimberly Boan, COTA
• Rishi Tushar Bodalia, DC
• Connie Jeanne Bodnarik
• Kathryn Boehm
• Geoffrey Boehme

• Dermatology Physician in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.