Individual provider Active NPI

Cynthia Bantista, APN

  • Family Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1124596796
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11000152 Issued in FL
Practice address
8100 N Davis Hwy
Pensacola, FL 32514-6093
Phone
(850) 477-2466
NPI assigned
Nov 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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 209018443 IL
Family Nurse Practitioner 363LF0000X 11000152 FL Primary

Addresses

Primary practice location

8100 N Davis Hwy
Pensacola, FL 32514-6093

Mailing address

8100 N Davis Hwy
Pensacola, FL 32514-6093

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
I20190610000161 FL Practitioner - Nurse Practitioner 9739412651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic LLC 576 clinicians

Practice addresses (Care Compare)

2090 S Hwy 29
Cantonment, FL 32533-8699
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11000152FLMDFamily Nurse Practitioner
209018443ILMDFamily Nurse Practitioner

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
Hygienic Institute for Lasalle, Peru and Oglesby Current Accepting new patients
Minuteclinic LLC Family CurrentSince May 15, 2019 Accepting new patients

Locations

2090 S Highway 29
Cantonment, FL 32533
Phone (850) 937-0122

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

8100 N Davis Hwy
Pensacola, FL 32514
Phone (850) 454-9934

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

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.

NPI Registry JSON

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1124596796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146093",
            "telephone_number": "850-477-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANTISTA",
        "first_name": "CYNTHIA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018443",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11000152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.