Selena Crandall, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9238210 Issued in FL

Practice address

3860 Sun City Center Blvd
Ruskin, FL 33573-6806

Phone

(813) 633-1980

Fax

(813) 355-5104

NPI assigned

Feb 18, 2014

Last updated

Sep 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Ocean Dermatology LLCGroup PAC ID 3779729603, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: selenac@blueoceanderm.emadirect.md

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

• Blue Ocean Dermatology LLC

  • Dermatology Physician
  • Port Orange, FL
  • NPI 1992045272
  Medicare reassignment Care Compare group NPD
• Ohi West Medical Group II LLC

  • General Practice Physician
  • Zephyrhills, FL
  • NPI 1982381299
  Medicare reassignment NPD
• Ohi West Medical Group II LLC

  dba Florida Medical Clinic Orlando Health

  • Durable Medical Equipment & Medical Supplies
  • Wesley Chapel, FL
  • NPI 1427814847
  NPD
• Blue Ocean Deramtology LLC

  • Dermatology Physician
  • Palm Coast, FL
  • NPI 1164309605
  NPD (past)
• Blue Ocean Deramtology LLC

  • Dermatology Physician
  • New Smyrna Beach, FL
  • NPI 1184501611
  NPD (past)
• Blue Ocean Deramtology LLC

  • Dermatology Physician
  • Daytona Beach, FL
  • NPI 1689551129
  NPD (past)
• Dermatology on the Spot, LLC

  • Dermatology Physician
  • Port Orange, FL
  • NPI 1487058533
  NPD (past)

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1043635675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "813-528-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 SUN CITY CENTER BLVD",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335736806",
            "telephone_number": "813-633-1980",
            "fax_number": "813-355-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "SELENA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9238210",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9238210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014924000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ashley Melissa Corral, DNP, FNC-BC
• Nichole White Coyne, LCSW
• Kimberly Ann Crawford
• Vanity Crumby
• Catherine Ivette Cruz
• Cup Chronicles Transportation Services, LLC.
• Ferdonia Cusseaux, RN

• Family Nurse Practitioner in Ruskin, FL
• Providers in Ruskin, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.