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JEANIACIEUSE THEODORE
NPI 1285450155
Nurse Practitioner - Family in Port Saint Lucie, FL

Active since November 25, 2024PECOS EnrolledAccepts Medicare Assignment
1801 SE HILLMOOR DR STE C104C103, PORT SAINT LUCIE, FL 34952(772) 742-2111 Get Directions Write a Review

NPPES record last updated: January 23, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jeaniacieuse Theodore NPPES

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

JEANIACIEUSE THEODORE (NPI 1285450155) is an individual family provider in Port Saint Lucie, Florida, licensed in Florida (11036138) and active in the NPI registry since November 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1285450155
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJEANIACIEUSE THEODORE
Location Address1801 SE HILLMOOR DR STE C104C103Port Saint Lucie, FL 34952-7553
Mailing Address1701 Se Hillmoor Dr Ste 7Port Saint Lucie, FL 34952-7552 · (772) 480-5860
Phone(772) 742-2111
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateNovember 25, 2024
Last NPPES UpdateJanuary 23, 2025
NPPES CertifiedJanuary 23, 2025
✔ NPI 1285450155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in FL · 11036138
1801 SE HILLMOOR DR STE C104C103, Port Saint Lucie, FL 34952
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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

Jeaniacieuse Theodore 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 ID9234667056
PECOS Enrollment IDI20250107004119
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34952 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.

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 Jeaniacieuse Theodore's NPI number?

The NPI number for Jeaniacieuse Theodore is 1285450155. It was assigned to this individual provider in the NPPES registry on November 25, 2024.

Where is Jeaniacieuse Theodore located?

Jeaniacieuse Theodore practices at 1801 SE Hillmoor Dr Ste C104c103, Port Saint Lucie, FL 34952. The listed phone number is (772) 742-2111.

What is Jeaniacieuse Theodore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jeaniacieuse Theodore enrolled in Medicare?

Yes. Jeaniacieuse Theodore is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jeaniacieuse Theodore was last updated on January 23, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.