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RATTANAVALEE JANSOD HAVLAT APRN
NPI 1124761093
Nurse Practitioner - Adult Health in Fort Walton Beach, FL

Active since April 18, 2022PECOS Enrolled
1118 HOSPITAL RD, FORT WALTON BEACH, FL 32547(850) 862-3415 Get Directions Write a Review

NPPES record last updated: March 5, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 5, 2025, Mar 2, 2023, Apr 18, 2022 (3 updates tracked since 2022).

About Rattanavalee Jansod Havlat Aprn NPPES

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

RATTANAVALEE JANSOD HAVLAT APRN (NPI 1124761093) is an individual adult health provider in Fort Walton Beach, Florida, licensed in Florida (APRN11018735) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124761093
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameRATTANAVALEE JANSOD HAVLATCredential: APRN
Location Address1118 HOSPITAL RDFort Walton Beach, FL 32547-6742
Mailing Address1118 Hospital RdFort Walton Beach, FL 32547-6742 · (850) 862-3415
Phone(850) 862-3415
Sole ProprietorYes
Enumeration DateApril 18, 2022
Last NPPES UpdateMarch 5, 20253 updates tracked since enumeration
NPPES CertifiedMarch 5, 2025
✔ NPI 1124761093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in FL · APRN11018735
1118 HOSPITAL RD, Fort Walton Beach, FL 32547
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rattanavalee Jansod Havlat Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Rattanavalee Havlat reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Saint George Medical Center Inc
Same address
Geriatric Medicine
1118 HOSPITAL RD
Fort Walton Beach, FL 32547
  • Reassigned Medicare billing, Florida enrollment
  • 2 clinicians in this Medicare group
NPI 1184137929 (850) 862-3415

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32547 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing
99%631 patients4/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
96%513 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 2

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

SAINT GEORGE MEDICAL CENTER INC
Family Medicine (Geriatric Medicine)
1118 HOSPITAL RD
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 862-3415
MRS. BRENDA ANAIS RAMIREZ NURSE PRACTITIONER
Nurse Practitioner (Family)
1118 HOSPITAL RD
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 862-3415

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rattanavalee Havlat's NPI number?

The NPI number for Rattanavalee Havlat is 1124761093. It was assigned to this individual provider in the NPPES registry on April 18, 2022.

Where is Rattanavalee Havlat located?

Rattanavalee Havlat practices at 1118 Hospital Rd, Fort Walton Beach, FL 32547. The listed phone number is (850) 862-3415.

What is Rattanavalee Havlat's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Rattanavalee Havlat enrolled in Medicare?

Yes. Rattanavalee Havlat is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Rattanavalee Havlat's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Rattanavalee Havlat reassigns Medicare benefits to Saint George Medical Center Inc (Fort Walton Beach, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Rattanavalee Havlat's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Rattanavalee Havlat was last updated on March 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.