Individual provider Active NPI

Anisley Robaina, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1124584818
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11001518 Issued in FL
Practice address
13685 Doctors Way Ste 170
Fort Myers, FL 33912-4337
Phone
(239) 440-6456
Fax
(239) 236-0337
NPI assigned
Feb 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11001518 FL
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X NP95015524 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11001518 FL Primary

Addresses

Primary practice location

13685 Doctors Way Ste 170
Fort Myers, FL 33912-4337

Mailing address

1306 SW 35TH Ter
Cape Coral, FL 33914-5152
Phone (239) 601-5055

Other identifiers 1

IdentifierTypeStateIssuer
APRN11001518OtherFLAPRN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MI, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190402001310 FL Practitioner - Nurse Practitioner 3072854967 Reassigns benefits to 2 organizations
I20201005000487 MI Practitioner - Nurse Practitioner 3072854967 Reassigns benefits to 1 organization
I20201012002558 CA Practitioner - Nurse Practitioner 3072854967 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95015524CAMDFamily Nurse Practitioner
APRN11001518FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Episource LLC Multi-Specialty CurrentSince Apr 24, 2020 Accepting new patients
Central Health Plan of California, Inc. Multi-Specialty CurrentSince Feb 11, 2025 Accepting new patients

Locations

500 W 190th St
Fl 4
Gardena, CA 90248
Phone (424) 292-2923

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

12332 Race Track Rd
Tampa, FL 33626
Phone (813) 756-4383

Interoperability endpoints

  • Direct secure messaging: arobaina10051@direct-prd.molinahealthcare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1124584818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 SW 35TH TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339145152",
            "telephone_number": "239-601-5055",
            "fax_number": "239-204-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13685 DOCTORS WAY STE 170",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124337",
            "telephone_number": "239-440-6456",
            "fax_number": "239-236-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBAINA",
        "first_name": "ANISLEY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-18",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11001518",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95015524",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11001518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "APRN11001518",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.