Individual provider Active NPI

Marie E. Labadie-Degennaro, APRN

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1053808790
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9292695 Issued in FL
Practice address
13330 Usf Laurel Dr
Tampa, FL 33612-6601
Phone
(813) 974-2201
NPI assigned
Apr 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9292695 FL Primary

Addresses

Primary practice location

13330 Usf Laurel Dr
Tampa, FL 33612-6601

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other practice location 1

12220 Cortez Blvd
Brooksville, FL 34613
Phone (352) 556-5216

Other identifiers 1

IdentifierTypeStateIssuer
024984200MedicaidFL

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
I20180627002282 FL Practitioner - Nurse Practitioner 6507112935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Medical Service Association IncGroup PAC ID 6800790221, 818 clinicians

Practice addresses (Care Compare)

4001 E Fletcher Ave
Tampa, FL 33613-4808
Phone (813) 866-1600

4202 E Fowler Ave
Tampa, FL 33620-6750

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9292695FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Care One of Florida LLC CurrentSince May 6, 2018 Accepting new patients
University Medical Service Association Inc CurrentSince Dec 17, 2019 Accepting new patients
University Medical Service Association Inc CurrentSince Dec 17, 2019 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

12220 Cortez Blvd
Brooksville, FL 34613
Phone (352) 556-5216

7117 State Road 52
Hudson, FL 34667
Phone (727) 866-2128

11115 County Line Rd
Spring Hill, FL 34609
Phone (352) 666-9990

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103

5802 N 30th St
Tampa, FL 33610
Phone (813) 236-5100

13330 Usf Laurel Dr
Fl 3
Tampa, FL 33612
Phone (813) 396-9422

13330 Usf Laurel Dr
Tampa, FL 33612
Phone (813) 396-9478

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

4001 E Fletcher Ave
Tampa, FL 33613
Phone (813) 866-1600

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mlabadiedegennaro167424@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 6

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": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1053808790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13330 USF LAUREL DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336126601",
            "telephone_number": "813-974-2201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12220 Cortez Blvd",
            "address_purpose": "LOCATION",
            "city": "Brooksville",
            "state": "FL",
            "postal_code": "34613",
            "country_code": "US",
            "telephone_number": "352-556-5216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LABADIE-DEGENNARO",
        "first_name": "MARIE",
        "middle_name": "E.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9292695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024984200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.