Individual provider Active NPI

Jensine Largado Caudill, FNP-C

  • Adult Health Nurse Practitioner
  • Ocoee, FL
National Provider Identifier
1114681525
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11014797 Issued in FL
Practice address
10000 W Colonial Dr Ste 289
Ocoee, FL 34761-3432
Phone
(321) 842-4765
Fax
(321) 842-4767
NPI assigned
Oct 22, 2021
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 11014797 FL
Adult Health Nurse Practitioner 363LA2200X APRN11014797 FL Primary

Addresses

Primary practice location

10000 W Colonial Dr Ste 289
Ocoee, FL 34761-3432

Mailing address

10000 W Colonial Dr Ste 289
Ocoee, FL 34761-3432
Phone (321) 842-4765

Other practice location 1

2716 Rew Cir Ste 100
Ocoee, FL 34761-4201
Phone (407) 347-0666

Other identifiers 1

IdentifierTypeStateIssuer
112617800MedicaidFL

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
I20211122000740 FL Practitioner - Nurse Practitioner 4789073388 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

10000 W Colonial Dr
Suite 289
Ocoee, FL 34761-3432
Phone (407) 296-1910

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11014797FLMDAdult Health Nurse Practitioner
11014797FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adnan a Khan MD LLC CurrentSince Nov 1, 2021 Accepting new patients
Seniorcare USA LLC CurrentSince Nov 1, 2021 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

10000 W Colonial Dr
Ste 289
Ocoee, FL 34761
Phone (407) 296-1911

2716 Rew Cir
Ste 100
Ocoee, FL 34761
Phone (407) 347-0666

2706 Rew Cir
Ocoee, FL 34761
Phone (321) 842-4800

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1114681525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR STE 289",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613432",
            "telephone_number": "321-842-4765",
            "fax_number": "321-842-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR STE 289",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613432",
            "telephone_number": "321-842-4765",
            "fax_number": "321-842-4767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2716 Rew Cir Ste 100",
            "address_purpose": "LOCATION",
            "city": "Ocoee",
            "state": "FL",
            "postal_code": "347614201",
            "country_code": "US",
            "telephone_number": "407-347-0666",
            "fax_number": "407-347-0570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAUDILL",
        "first_name": "JENSINE",
        "middle_name": "LARGADO",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11014797",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11014797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112617800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.