Individual provider Active NPI

Steven Mark Anthony Requena, NP

  • Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1063258994
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11035022 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-8553
Phone
(352) 273-5159
NPI assigned
Jul 1, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 352149 NY
Nurse Practitioner 363L00000X APRN11035022 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-8553

Mailing address

PO Box 740861
Atlanta, GA 30374-0861
Phone (904) 819-4539

Other practice location 1

120 Palencia Village Dr Ste 107
Saint Augustine, FL 32095-8553
Phone (904) 819-3200

Other identifiers 1

IdentifierTypeStateIssuer
126787600MedicaidFL

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
I20250402003457 FL Practitioner - Nurse Practitioner 7315476157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Villages Regional Hospital Physician Services LLCGroup PAC ID 0244688893, 198 clinicians

Practice addresses (Care Compare)

10435 SE 170TH PL
Summerfield, FL 34491-8998
Phone (352) 255-3615

120 Palencia Village Dr
Saint Augustine, FL 32095-8553
Phone (904) 819-3200

Hospital & facility affiliations

  • Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
352149NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Villages Regional Hospital Physician Services LLC CurrentSince May 12, 2025 Accepting new patients
Flagler Professional Health Care Services, Inc. CurrentSince Apr 7, 2025 Accepting new patients
Flagler Professional Health Care Services, Inc. Nurse Practitioner CurrentSince Apr 7, 2025 Accepting new patients
Flagler Professional Health Care Services, Inc. Past Accepting new patients

Locations

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

120 Palencia Village Dr
Ste 107
Saint Augustine, FL 32095
Phone (904) 819-3200

120 Palencia Village Dr
Saint Augustine, FL 32095
Phone (904) 819-3200

100 Whetstone Pl
Ste 105
St Augustine, FL 32086
Phone (904) 824-3777

10435 SE 170th Pl
Summerfield, FL 34491
Phone (352) 245-7788

1501 N US Highway 441
The Villages, FL 32159
Phone (352) 544-7025

Interoperability endpoints

  • Direct secure messaging: srequena774443@direct.shands.ufl.edu

Organizations & group practices 4

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": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1063258994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740861",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740861",
            "telephone_number": "904-819-4539",
            "fax_number": "904-819-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326108553",
            "telephone_number": "352-273-5159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Palencia Village Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "Saint Augustine",
            "state": "FL",
            "postal_code": "320958553",
            "country_code": "US",
            "telephone_number": "904-819-3200",
            "fax_number": "904-819-3201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REQUENA",
        "first_name": "STEVEN",
        "middle_name": "MARK ANTHONY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-01",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "352149",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11035022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126787600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.