Summer Abukhodeir
Individual provider Active NPI Acute Care Nurse Practitioner · Lake Wales, FL
NPI 1104353168 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1104353168
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- ARNP9384750 (FL)
- Practice address
- 858 Redwood Way
Lake Wales, FL 33898-9130 - Phone
- (863) 232-7604
- NPI assigned
- May 20, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Doctor on Demand Professionals P C
Practice addresses (Care Compare)
1201 Hays St
Tallahassee, FL 32301-2699
Phone (800) 997-6196
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in FL, IL, CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170819000234 | FL | Practitioner - Nurse Practitioner | 8022380427 | Reassigns benefits to 4 organizations |
| I20260527002471 | IL | Practitioner - Nurse Practitioner | 8022380427 | Reassigns benefits to 1 organization |
| I20260608003599 | CO | Practitioner - Nurse Practitioner | 8022380427 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doctor on Demand Professionals P C | Current |
Accepting new patients | |
| Imad Al-Nakshabendi M D P a | Current |
Accepting new patients | |
| Bay Area Nutrition Inc | Past |
Accepting new patients |
Locations
1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926
275 Battery St
Ste 650
San Francisco, CA 94111
Phone 4155043838104
1201 Hays St
Tallahassee, FL 32301
Phone (855) 522-7233
14486 University Cove Pl
Tampa, FL 33613
Phone (813) 252-2770
211 E 7th St
Ste 620
Austin, TX 78701
Phone (415) 742-8411
Interoperability endpoints
- summer.abukhodeir.1@30520.direct.athenahealth.com
- sabukhodeir168169@direct.tgh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | ARNP9384750 | FL | Yes |
Addresses
Primary practice location
858 Redwood Way
Lake Wales, FL 33898-9130
Mailing address
PO Box 917770
Orlando, FL 32891-0001
Phone (813) 974-2201
Other practice location 1
4202 E Fowler Ave Stop Shs100
Tampa, FL 33620-9130
Phone (813) 974-2201
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J2DQT | Other | FL | BLUE CROSS BLUE SHIELD |
| 105431300 | Medicaid | FL | |
| L6972 | Other | FL | MEDICARE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sabukhodeir168169@direct.tgh.org |
Other providers in Lake Wales, FL
- Aakash LLC
- Accurate Pathology Services MD PL
- Abiola Abiodun Adeyemo
- Adult Family Care Home
- Advance Technological Radiology, PA
- Advanced Interventional Cardiology Consultants
All providers in Lake Wales, FL · Acute Care Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.