Individual provider Active NPI

Mischa Nicole Tice, ARNP

  • Nurse Practitioner
  • Temple Terrace, FL
National Provider Identifier
1043076755
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11030631 Issued in FL
Practice address
13020 N Telecom Pkwy
Temple Terrace, FL 33637-0915
Phone
(228) 363-4729
NPI assigned
Feb 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11030631 FL Primary

Addresses

Primary practice location

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0915

Mailing address

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925
Phone (228) 363-4729

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
I20240321003397 FL Practitioner - Nurse Practitioner 4486091758 Reassigns benefits to 2 organizations

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
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Tallahassee Orthopedic Clinic III PLGroup PAC ID 4284532755, 538 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

5901 E Fowler Ave
Suite 100
Temple Terrace, FL 33617-2305
Phone (813) 978-9700

Hospital & facility affiliations

  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11030631FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Musculoskeletal Institute Chartered CurrentSince Apr 15, 2024 Accepting new patients
Musculoskeletal Institute Chartered Current Accepting new patients
Tallahassee Orthopedic Clinic III PL CurrentSince Oct 1, 2024 Accepting new patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Oct 1, 2024 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Apr 15, 2024 Accepting new patients

Locations

560 S Lakewood Dr
Ste 101
Brandon, FL 33511
Phone (813) 657-8448

11286 Boyette Rd
Ste 101
Riverview, FL 33569

991 E Del Webb Blvd
Sun City Center, FL 33573
Phone (813) 633-5232

3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 210-1808

909 N Dale Mabry Hwy
Tampa, FL 33609
Phone (813) 287-9370

909 N Dale Mabry Hwy
Ste 201
Tampa, FL 33609
Phone (813) 287-9372

5016 W Cypress St
Ste 210
Tampa, FL 33607
Phone (813) 602-7896

13020 N Telecom Pkwy
Temple Terrace, FL 33637

5901 E Fowler Ave
Ste 100
Temple Terrace, FL 33617
Phone (813) 987-9700

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000

2653 Bruce B Downs Blvd
Ste 201
Wesley Chapel, FL 33544
Phone (813) 910-3368

2653 Bruce B Downs Blvd
Wesley Chapel, FL 33544
Phone (813) 324-1939

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mischa.tice.1@18802.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1043076755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370925",
            "telephone_number": "228-363-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370915",
            "telephone_number": "228-363-4729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICE",
        "first_name": "MISCHA",
        "middle_name": "NICOLE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11030631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.