Individual provider Active NPI

Jacqueline Shandelle Machaliwa

  • Home Health Aide
  • Tampa, FL
National Provider Identifier
1053829705
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
17401 Commerce Park Blvd Ste 1000
Tampa, FL 33647-3501
Phone
(813) 900-1118
NPI assigned
Jan 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

17401 Commerce Park Blvd Ste 1000
Tampa, FL 33647-3501

Mailing address

17401 Commerce Park Blvd Ste 1000
Tampa, FL 33647-3501
Phone (813) 900-1118

Other practice location 1

200 W Madison St
Chicago, IL 60606-3414
Phone (813) 900-1118

Other practice location 2

2429 Camden Oaks Pl
Valrico, FL 33594-4638
Phone (813) 900-1118

Other identifiers 2

IdentifierTypeStateIssuer
823901801MedicaidIL
823901801MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Be a Blessing Services Home Care LLC Home Health Aide Current Accepting new patients

Organizations & group practices 1

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": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1053829705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17401 COMMERCE PARK BLVD STE 1000",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473501",
            "telephone_number": "813-900-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17401 COMMERCE PARK BLVD STE 1000",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473501",
            "telephone_number": "813-900-1118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Madison St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606063414",
            "country_code": "US",
            "telephone_number": "813-900-1118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2429 Camden Oaks Pl",
            "address_purpose": "LOCATION",
            "city": "Valrico",
            "state": "FL",
            "postal_code": "335944638",
            "country_code": "US",
            "telephone_number": "813-900-1118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACHALIWA",
        "first_name": "JACQUELINE",
        "middle_name": "SHANDELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "823901801",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "823901801",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.