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MOSAIC MEDICINE, PLLC
NPI 1639827033
Nurse Practitioner - Family in Bradenton, FL

Active since March 15, 2022CLIA 10D2261037 · Waiver
3934 E STATE ROAD 64, BRADENTON, FL 34208(703) 677-1035(941) 200-4264 Get Directions Write a Review

NPPES record last updated: March 11, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 11, 2026, Dec 9, 2024 (2 updates tracked since 2024).

About Mosaic Medicine, Pllc NPPES

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

MOSAIC MEDICINE, PLLC (NPI 1639827033) is a healthcare organization registered as a family in Bradenton, Florida and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through May 24, 2028 and lists Cory Worthington Lucas, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1639827033
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameMOSAIC MEDICINE, PLLC
Location Address3934 E STATE ROAD 64Bradenton, FL 34208-9059
Mailing Address3934 E State Road 64Bradenton, FL 34208-9059 · (941) 777-5665 · Fax (941) 200-4264
Phone(703) 677-1035
Fax(941) 200-4264
Organization SubpartNo
Authorized OfficialCory Worthington LucasNurse Practitioner · (941) 777-5665
Enumeration DateMarch 15, 2022
Last NPPES UpdateMarch 11, 20262 updates tracked since enumeration
NPPES CertifiedMarch 11, 2026
✔ NPI 1639827033 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
3934 E STATE ROAD 64, Bradenton, FL 34208
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2261037

Mosaic Medicine, PLLC · Bradenton, FL
Active · expires May 24, 2028
CLIA Number10D2261037
Laboratory TypeConcierge Practice
Certificate Effective DateMay 25, 2026
Certificate Expiration DateMay 24, 2028
Laboratory DirectorCory W. Lucas
Laboratory Phone(941) 777-5665
Laboratory LocationMosaic Medicine, PLLC3934 Sr 64E, Bradenton, FL 34208
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

DSB VENTURES
Home Health
3934 E STATE ROAD 64
BRADENTON, FL 34208
Manatee County (941) 747-9922
NOUR JAMAL BABA
Physician Assistant
3934 E STATE ROAD 64
BRADENTON, FL 34208
Manatee County (941) 777-5665
CORY LUCAS NP
Nurse Practitioner (Family)
3934 E STATE ROAD 64
BRADENTON, FL 34208
Manatee County (941) 777-5665
MOSAIC MEDICINE URGENT CARE, PLLC
Clinic/Center (Urgent Care)
3934 E STATE ROAD 64
BRADENTON, FL 34208
Manatee County (941) 777-5665

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 Mosaic Medicine, PLLC's NPI number?

The NPI number for Mosaic Medicine, PLLC is 1639827033. It was assigned to this organization in the NPPES registry on March 15, 2022.

Where is Mosaic Medicine, PLLC located?

Mosaic Medicine, PLLC is located at 3934 E State Road 64, Bradenton, FL 34208. The listed phone number is (703) 677-1035.

What is Mosaic Medicine, PLLC's specialty?

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

Does Mosaic Medicine, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2261037) is associated with this NPI, valid through May 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mosaic Medicine, PLLC was last updated on March 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.