Individual provider Active NPI

Derrick Grondin, APRN

  • Adult Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1033007653
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11034993 Issued in FL
Practice address
1400 S Orange Ave # Mp706
Orlando, FL 32806-2134
Phone
(321) 843-8010
Fax
(321) 843-6330
NPI assigned
Jun 24, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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 APRN11034993 FL
Adult Health Nurse Practitioner 363LA2200X APRN11034993 FL Primary

Addresses

Primary practice location

1400 S Orange Ave # Mp706
Orlando, FL 32806-2134

Mailing address

1703 S Summerlin Ave
Orlando, FL 32806-4018
Phone (906) 458-5641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250805002053 FL Practitioner - Nurse Practitioner 5496263923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1400 S Orange Ave
Orlando, FL 32806-2134
Phone (321) 841-6600

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2025 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1400 S Orange Ave
#706
Orlando, FL 32806
Phone (321) 843-8010

1400 S Orange Ave
Orlando, FL 32806
Phone (321) 841-1893

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1033007653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 S SUMMERLIN AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328064018",
            "telephone_number": "906-458-5641",
            "fax_number": "321-843-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S ORANGE AVE # MP706",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062134",
            "telephone_number": "321-843-8010",
            "fax_number": "321-843-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONDIN",
        "first_name": "DERRICK",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11034993",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11034993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.