CAITLYN G PRUCINSKY (NPI# 1194720797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194720797 |
| Entity Type | Individual |
| Full Name | CAITLYN G PRUCINSKY |
| Other Name | CAITLYN GRAHAM BATES |
| Credential | PA |
| Practice Address |
1050 Se Monterey Rd Ste 400 Stuart FL 34994-4512 |
| Mailing Address |
250 N Shadeland Ave Ste 130 Provider Enrollment Indianapolis IN 46219-4959 |
| Practice Telephone | 7722882400 |
| Practice Fax Number | 7724190144 |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2020-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA111020 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | PA91111020 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
10000698A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9111020 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
10000698A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
10000698 | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9401 Sw Discovery Way Ste 102, Port St Lucie, FL 349872381 | 7722882400 | 7724190144 |
| 1801 N Senate Blvd, Suite 535, Indianapolis, IN 462021204 | 3179631950 | 3179631955 |
| 9401 Sw Discovery Way Ste 201, Port St Lucie, FL 349872381 | 7722882400 | 7724190144 |
| Street Address |
1050 SE MONTEREY RD STE 400 |
| City | STUART |
| State | FL |
| Zip Code | 34994-4512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942740360 | Susannah Johnson | Nurse Practitioner | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2017-03-04 |
| 1982065264 | Nicholas Demarco | Physician Assistant | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2016-03-14 |
| 1912363623 | Jayce Reed | Physician Assistant | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2016-01-11 |
| 1962836569 | Robert William Lambert | Physician Assistant | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2013-08-30 |
| 1568809937 | Chaquera Ernesta Jackson | Specialist/Technologist | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2013-05-26 |
| 1588950547 | Alan Ryan Blackburn II | Orthopaedic Surgery | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2011-06-28 |
| 1265744205 | Daniel A. Jones | Orthopaedic Surgery | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994 | 2010-07-07 |
| 1225221047 | Check C. Kam | Orthopaedic Surgery | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2007-08-24 |
| 1093837320 | Sharon Alicia Cain | Licensed Practical Nurse | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2007-04-06 |
| 1003999590 | Richard Anthony Planzo | Nurse Practitioner | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2006-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912543711 | Prestige Medical Billing. Inc | Durable Medical Equipment & Medical Supplies | 2678 Se Willoughby Blvd, Stuart, FL 34994 | 2019-11-27 |
| 1780229203 | Katherine Ginn | Occupational Therapist | 809 Se Central Parkway, Stuart, FL 34994 | 2019-11-07 |
| 1972167294 | Melissa Callaham Lcsw | Social Worker | 900 East Ocean Blvd., Suite D-130, Office 26, Stuart, FL 34994 | 2019-04-23 |
| 1053881300 | Spencer Perna | Chiropractor | 632 Se Monterey Rd., Stuart, FL 34994 | 2018-11-29 |
| 1720563521 | National Vision Inc | Technician/Technologist | 2600 Southeast Federal Highway, Stuart, FL 34994 | 2018-09-27 |
| 1649767351 | Frank Alario Md & Associates | Non-Pharmacy Dispensing Site | 721 South Colorado Avenue, Stuart, FL 34994 | 2018-04-18 |
| 1609305499 | Wideline Thelemaque-claire | Behavior Technician | 900 E Ocean Blvd, Suite 130d, Stuart, FL 34994 | 2017-06-06 |
| 1316488984 | Jessica Gaffney | Social Worker | 416 Se Balboa Ave., Suite 200, Stuart, FL 34994 | 2017-03-16 |
| 1578012035 | Essentials Medical Group, LLC | Internal Medicine | 2694 Se Willoughby Blvd, Stuart, FL 34994 | 2016-09-26 |
| 1356898324 | Waters Edge Dermatology Global LLC | Surgery | 2601 S Kanner Highway, Stuart, FL 34994 | 2016-09-07 |
| Find all providers in zip 34994 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477195790 | Caitlyn Diane Helm | Physician Assistant | 200 Se Hospital Ave, Stuart, FL 34994-2346 | 2019-10-09 |
| 1043750839 | Christopher Andrew Royall | Physician Assistant | 3801 S Kanner Hwy Ste 200, Stuart, FL 34994-4801 | 2017-02-28 |
| 1982065264 | Nicholas Demarco | Physician Assistant | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2016-03-14 |
| 1609208545 | Morgan Mathias Dembinski | Physician Assistant | 509 Se Riverside Dr Ste 303, Stuart, FL 34994-2579 | 2013-08-02 |
| 1083977805 | Brian B Foster | Physician Assistant | 509 Se Riverside Dr, Suite 203, Stuart, FL 34994-2579 | 2012-06-18 |
| 1205976487 | Sean Patrick Alonza Bannister | Physician Assistant | 501 Se Osceola St Ste 201, Stuart, FL 34994-2334 | 2007-02-07 |
| 1629022322 | Kym A Pallatto | Physician Assistant | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2006-05-19 |
| 1043289630 | Tara Ann Cobb | Physician Assistant | 1050 Se Monterey Rd, Suite 400, Stuart, FL 34994-4512 | 2006-03-16 |
| 1811966351 | Kevin Francis Barnewold | Physician Assistant | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2006-03-16 |
| 1871562728 | David P Hendry | Physician Assistant | 1050 Se Monterey Rd, Suite 400, Stuart, FL 34994-4512 | 2006-03-14 |
| Find all providers in STUART | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.