Individual provider Active NPI

Betsy S Carrasquillo

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1104658608
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11034568 Issued in FL
Practice address
5381 Primrose Lake Cir
Tampa, FL 33647-3521
Phone
(813) 615-2488
NPI assigned
Aug 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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 11034568 FL Primary

Addresses

Primary practice location

5381 Primrose Lake Cir
Tampa, FL 33647-3521

Mailing address

111 Lake Hollingsworth Dr
Lakeland, FL 33801-5607
Phone (863) 680-4111

Other practice location 1

111 Lake Hollingsworth Dr
Lakeland, FL 33801-5607
Phone (863) 680-4111

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
I20241205001455 FL Practitioner - Nurse Practitioner 9133655897 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Nxpath Urology LLCGroup PAC ID 6800386087, 7 clinicians
Primary Care Solutions and More LLCGroup PAC ID 0244621910, 36 clinicians
Tampa Hospitalists and Extended Care Providers PAGroup PAC ID 2567838675, 4 clinicians
New Tampa Medical Center PAGroup PAC ID 2860493491, 3 clinicians

Practice addresses (Care Compare)

1605 NW Federal Hwy
Stuart, FL 34994-9629
Phone (772) 480-5860

1701 SE Hillmoor Dr
Port Saint Lucie, FL 34952-7552
Phone (772) 480-5860

5381 Primrose Lake Cir
Tampa, FL 33647-3521
Phone (813) 615-2488

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11034568FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Tampa Medical Center PA CurrentSince Feb 27, 2025 Accepting new patients
Tampa Hospitalists and Extended-Care Providers, P.a. CurrentSince Mar 13, 2025 Accepting new patients
Comprehensive Hematology Oncology LLC CurrentSince Dec 1, 2024 Accepting new patients
Comprehensive Hematology Oncology LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

3501 Cortez Rd W
Bradenton, FL 34210
Phone (941) 752-2700

425 S Parsons Ave
Ste 101
Brandon, FL 33511
Phone (813) 278-5062

5000 Park St N
Ste 1017
St Petersburg, FL 33709
Phone (727) 344-6570

5381 Primrose Lake Cir
Tampa, FL 33647
Phone (813) 615-2488

3611 Little Rd
Trinity, FL 34655
Phone (727) 312-4300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADHCAD/Endpoint/ADHCAD

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.

NPI Registry JSON

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1104658608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 LAKE HOLLINGSWORTH DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015607",
            "telephone_number": "863-680-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5381 PRIMROSE LAKE CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473521",
            "telephone_number": "813-615-2488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Lake Hollingsworth Dr",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338015607",
            "country_code": "US",
            "telephone_number": "863-680-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRASQUILLO",
        "first_name": "BETSY",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11034568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.