Florida Atlantic University
NPI 1164591954ActiveOrganization· Nurse Practitioner, Gerontology· Boca Raton, FL
Nurse Practitioner, Gerontology in Boca Raton, Florida, registered in NPPES in November 2006, part of Florida Atlantic University. The authorized official on file is Louisa Pontiroli-Kelly, Authorized Official. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1164591954 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Florida Atlantic University |
| NPI issued | Nov 7, 2006 |
| Last updated in NPPES | Dec 15, 2025 |
| Certified by provider | Dec 15, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Gerontology Primary | 363LG0600X | — | — |
| Clinical Neuropsychologist | 103G00000X | — | — |
| Psychologist, Clinical | 103TC0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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