Individual provider Active NPI

Lisandra Bienvenida Mejia, APRN

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1114643277
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11022150 Issued in FL
Practice address
2400 N Orange Blossom TRL Ste 302
Kissimmee, FL 34744-2308
Phone
(407) 932-6193
Fax
(407) 932-6194
NPI assigned
Oct 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11022150 FL
Family Nurse Practitioner 363LF0000X APRN11022150 FL Primary

Addresses

Primary practice location

2400 N Orange Blossom TRL Ste 302
Kissimmee, FL 34744-2308

Mailing address

2400 N Orange Blossom TRL Ste 302
Kissimmee, FL 34744-2308
Phone (407) 932-6193

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
I20230116000012 FL Practitioner - Nurse Practitioner 6901277763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11022150FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Nurse Practitioner CurrentSince Jan 30, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jan 30, 2023 Accepting new patients

Locations

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

2400 N Orange Blossom Trl
Ste 302
Kissimmee, FL 34744
Phone (407) 932-6193

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: lmejia435134@adventhealth.direct-ci.com

Organizations & group practices 2

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": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1114643277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N ORANGE BLOSSOM TRL STE 302",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347442308",
            "telephone_number": "407-932-6193",
            "fax_number": "407-932-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N ORANGE BLOSSOM TRL STE 302",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347442308",
            "telephone_number": "407-932-6193",
            "fax_number": "407-932-6194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "LISANDRA",
        "middle_name": "BIENVENIDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11022150",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11022150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.