JAQUELINE SOUSA CARVALHO FNP-BC
NPI 1003649476
Nurse Practitioner in Fort Myers, FL

Q: What is Jaqueline Sousa Carvalho's NPI number?

The NPI number for Jaqueline Sousa Carvalho is 1003649476. It was assigned to this individual provider in the NPPES registry on August 21, 2024.

Q: What is Jaqueline Sousa Carvalho's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since August 21, 2024PECOS EnrolledAccepts Medicare Assignment

12651 WHITEHALL DR, FORT MYERS, FL 33907(239) 424-2030(239) 343-4117 Get Directions Write a Review

NPPES record last updated: February 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 7, 2025, Aug 21, 2024 (2 updates tracked since 2024).

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About Jaqueline Sousa Carvalho Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAQUELINE SOUSA CARVALHO FNP-BC (NPI 1003649476) is an individual nurse practitioner in Fort Myers, Florida, licensed in Florida (APRN11033857) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS, is affiliated with Lee Memorial Hospital, and maintains a secondary practice location in Cape Coral.

NPPES Registry Identity

NPI1003649476

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameJAQUELINE SOUSA CARVALHOCredential: FNP-BC

Location Address12651 WHITEHALL DRFort Myers, FL 33907-3626

Mailing AddressPo Box 2147Fort Myers, FL 33902-2147 · (239) 343-7130 · Fax (239) 343-7185

Phone(239) 424-2030

Fax(239) 343-4117

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateAugust 21, 2024

Last NPPES UpdateFebruary 7, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 7, 2025

✔ NPI 1003649476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in FL · APRN11033857

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedUrologyTaxonomy 208800000X · License APRN11033857 (FL)

12651 WHITEHALL DR, Fort Myers, FL 33907

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Secondary Practice Location 1

Location 11206 Country Club BlvdCape Coral, FL 33990-2180 · Phone (239) 226-2727

Other Identifiers 1

Medicaid125563500FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jaqueline Sousa Carvalho Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608391396

PECOS Enrollment IDI20250415002256

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lee Memorial Hospital

Acute Care Hospitals · Fort Myers, FL

5/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100012

Location2776 Cleveland AveFort Myers, FL 33901 · Lee County

Emergency services Birthing friendly

Cape Coral Hospital

Acute Care Hospitals · Cape Coral, FL

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100244

Location636 Del Prado BlvdCape Coral, FL 33990 · Lee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33907 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$91.69 typical visit price

range $58.56 – $179.05

Typical copayment $22.92 (range $14.64 – $44.76)

Most-billed visit code 99203

Established Patient

$103.21 typical visit price

range $18.44 – $144.68

Typical copayment $25.80 (range $4.61 – $36.17)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAFAEL ANGEL PENA GARCIA APRN, FNP-C

Nurse Practitioner