Mr Fernando M Ulloa, APRN in Palm Coast, FL - Medicare Nurse Practitioner

Mr Fernando M Ulloa, APRN is a medicare enrolled "Nurse Practitioner - Adult Health" in Palm Coast, Florida. His current practice location is 61 Memorial Medical Pkwy Ste 3803, Palm Coast, Florida. You can reach out to his office (for appointments etc.) via phone at (718) 721-1674.

Mr Fernando M Ulloa is licensed to practice in Florida (license number APRN11025366) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1043459563.

Contact Information

	Mr Fernando M Ulloa, APRN
	61 Memorial Medical Pkwy Ste 3803, Palm Coast, FL 32164-5982
	(718) 721-1674
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Fernando M Ulloa
Gender	Male
Speciality	Nurse Practitioner - Adult Health
Location	61 Memorial Medical Pkwy Ste 3803, Palm Coast, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1043459563
Provider Enumeration Date: 02/05/2009
Last Update Date: 06/12/2025

Medicare PECOS Information:

PECOS PAC ID: 6103350780
Enrollment ID: I20241115001196

Medical Identifiers

Medical identifiers for Mr Fernando M Ulloa such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043459563	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	574074-1 (New York)	Secondary
163W00000X	Registered Nurse	RN9623430 (Florida)	Secondary
363LA2200X	Nurse Practitioner - Adult Health	APRN11025366 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Fernando M Ulloa allows following entities to bill medicare on his behalf.

Entity Name	Infectious Diseases Of Mid-florida, Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396837308 PECOS PAC ID: 9032123526 Enrollment ID: O20060206000052

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Fernando M Ulloa is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Fernando M Ulloa, APRN Po Box 350137, Palm Coast, FL 32135-0137 Ph: (718) 721-1674	Mr Fernando M Ulloa, APRN 61 Memorial Medical Pkwy Ste 3803, Palm Coast, FL 32164-5982 Ph: (718) 721-1674

Reviews and Comments

Nurse Practitioner Nurses in Palm Coast, FL

Jennifer A Schroeder, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 61 Memorial Medical Pkwy Ste 2812, Palm Coast, FL 32164 Phone: 386-586-1860 Fax: 386-586-1861
Vivian Del Carmen Medina, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 14 Office Park Dr Ste 6, Palm Coast, FL 32137 Phone: 407-299-7333
Jennifer Marie Agosto, ACNPC-AG Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 60 Piedmont Dr, Palm Coast, FL 32164 Phone: 305-588-0373
Amanda Vera, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 61 Memorial Medical Pkwy Ste 2815, Palm Coast, FL 32164 Phone: 386-586-1810 Fax: 386-586-1811
Traci Serrano, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 61 Memorial Medical Pkwy Ste 3816, Palm Coast, FL 32164 Phone: 386-586-1720
Mrs. Venus M. Valliere, ARNP BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 20 Cypress Point Pkwy Ste A, Palm Coast, FL 32164 Phone: 386-586-7005 Fax: 844-867-3940
Mrs. Suzanne Korum, ARNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 20 Cypress Point Pkwy Ste A, Palm Coast, FL 32164 Phone: 386-586-7005 Fax: 844-867-3940

Mr Fernando M Ulloa, APRN - Medicare Nurse Practitioner in Palm Coast, FL