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PREMIUM PRIMARY CARE & WALK-IN CLINIC INC
NPI 1700654167
Family Medicine in Port St Lucie, FL

Active since December 15, 2023
1801 SE HILLMOOR DR UNIT A-107P, PORT ST LUCIE, FL 34952(772) 446-0950(772) 446-0956 Get Directions Write a Review

NPPES record last updated: December 15, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Premium Primary Care & Walk-in Clinic Inc NPPES

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

PREMIUM PRIMARY CARE & WALK-IN CLINIC INC (NPI 1700654167) is a healthcare organization registered as a family medicine in Port St Lucie, Florida and active in the NPI registry since December 2023. The organization lists Patrick A Vergel De Dios, Aprn, as its authorized official.

NPPES Registry Identity

NPI1700654167
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePREMIUM PRIMARY CARE & WALK-IN CLINIC INC
Location Address1801 SE HILLMOOR DR UNIT A-107PPort St Lucie, FL 34952-7553
Mailing Address1801 Se Hillmoor Dr Unit A-107pPort St Lucie, FL 34952-7553 · (772) 446-0950 · Fax (772) 446-0956
Phone(772) 446-0950
Fax(772) 446-0956
Organization SubpartNo
Authorized OfficialPatrick A Vergel De DiosAprn · (772) 446-0950
Enumeration DateDecember 15, 2023
NPPES CertifiedDecember 15, 2023
✔ NPI 1700654167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1801 SE HILLMOOR DR UNIT A-107P, Port St Lucie, FL 34952
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Premium Primary Care & Walk-in Clinic Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Premium Primary Care & Walk-In Clinic Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Patrick Vergel De Dios, ARNP, FNP-C
Nurse Practitioner
NPI 1760993786
1801 SE HILLMOOR DR STE A-107
Port St Lucie, FL 34952
(772) 446-0950
✔ PECOS✔ Accepts MedicareSame address
Srinivas Boppana, D.O.
Family Practice
NPI 1679839252
5130 SUNFOREST DR STE 300
Tampa, FL 33634
(727) 824-0780
✔ PECOS✔ Accepts Medicare147 mi

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

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 Premium Primary Care & Walk-In Clinic Inc's NPI number?

The NPI number for Premium Primary Care & Walk-In Clinic Inc is 1700654167. It was assigned to this organization in the NPPES registry on December 15, 2023.

Where is Premium Primary Care & Walk-In Clinic Inc located?

Premium Primary Care & Walk-In Clinic Inc is located at 1801 SE Hillmoor Dr Unit A-107p, Port St Lucie, FL 34952. The listed phone number is (772) 446-0950.

What is Premium Primary Care & Walk-In Clinic Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Premium Primary Care & Walk-In Clinic Inc enrolled in Medicare?

Yes. Premium Primary Care & Walk-In Clinic Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Premium Primary Care & Walk-In Clinic Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Premium Primary Care & Walk-In Clinic Inc, in Family Practice and Nurse Practitioner. A 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 the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Premium Primary Care & Walk-In Clinic Inc was last updated on December 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.