NPIMap

Individual provider Active NPI

Alyssa Ptacek, DNP, AGACNP-BC

  • Gerontology Nurse Practitioner
  • Celebration, FL
National Provider Identifier
1023854346
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11033797 Issued in FL
Practice address
400 Celebration PL
Celebration, FL 34747-4970
Phone
(407) 303-4000
NPI assigned
Jul 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11033797 FL
Gerontology Nurse Practitioner 363LG0600X APRN11033797 FL Primary

Addresses

Primary practice location

400 Celebration PL
Celebration, FL 34747-4970

Mailing address

400 Celebration PL
Celebration, FL 34747-4970
Phone (407) 303-7283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240806001241 FL Practitioner - Nurse Practitioner 6901343185 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11033797FLMDNurse Practitioner

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Sep 9, 2024 Accepting new patients
Florida Hospital Medical Group Inc Nurse Practitioner CurrentSince Sep 9, 2024 Accepting new patients

Locations

400 Celebration Pl
Kissimmee, FL 34747
Phone (407) 303-4000

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: aptacek3928837@adventhealth.direct-ci.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group Inc 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

400 Celebration PL
Celebration, FL 34747-4970

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1023854346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CELEBRATION PL",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474970",
            "telephone_number": "407-303-7283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CELEBRATION PL",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474970",
            "telephone_number": "407-303-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PTACEK",
        "first_name": "ALYSSA",
        "name_prefix": "Dr.",
        "credential": "DNP,  AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-05",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11033797",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11033797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.