Individual provider Active NPI

Jessica Cipolla, ARNP

  • Nurse Practitioner
  • Newberry, FL
National Provider Identifier
1043986813
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11014414 Issued in FL
Practice address
25545 NW 8TH Rd
Newberry, FL 32669-3397
Phone
(352) 575-3277
NPI assigned
Aug 20, 2021
Last updated
Sep 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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 APRN11014414 FL Primary
Family Nurse Practitioner 363LF0000X APRN11014414 FL

Addresses

Primary practice location

25545 NW 8TH Rd
Newberry, FL 32669-3397

Mailing address

PO Box 100264
Gainesville, FL 32610-0264
Phone (352) 273-5199

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-3397
Phone (352) 273-5199

Other names 1

  • Jessica Frederick Former name

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
I20210927001489 FL Practitioner - Nurse Practitioner 7214334713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11014414FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Sep 22, 2021 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Sep 22, 2021 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1600 SW Archer Rd
#D1121
Gainesville, FL 32610
Phone (352) 265-8989

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

6201 W Newberry Rd
Gainesville, FL 32605
Phone (352) 265-2020

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jcipolla65080@direct.shands.ufl.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1043986813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100264",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100264",
            "telephone_number": "352-273-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25545 NW 8TH RD",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "326693397",
            "telephone_number": "352-575-3277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103397",
            "country_code": "US",
            "telephone_number": "352-273-5199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIPOLLA",
        "first_name": "JESSICA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11014414",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11014414",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "FREDERICK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newberry, FL

Sources for this page

Verify at the official NPI Registry.