Individual provider Active NPI

Sara Rose Caracostas, APRN

  • Family Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1134901465
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11024986 Issued in FL
Practice address
519A E Bloomingdale Ave Ste a
Brandon, FL 33511-8105
Phone
(813) 655-4100
Fax
(813) 655-1775
NPI assigned
Oct 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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 APRN11024986 FL Primary

Addresses

Primary practice location

519A E Bloomingdale Ave Ste a
Brandon, FL 33511-8105

Mailing address

519A E Bloomingdale Ave Ste a
Brandon, FL 33511-8105
Phone (813) 655-4100

Other practice location 1

13111 US Highway 301 S
Riverview, FL 33578-7401
Phone (813) 671-0064

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
I20231128003737 FL Practitioner - Nurse Practitioner 4385092568 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11024986FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brandon-Riverview Medical Associates PA CurrentSince Nov 6, 2023 Accepting new patients

Locations

519 E Bloomingdale Ave
Ste A
Brandon, FL 33511
Phone (813) 655-4100

13111 US Highway 301 S
Riverview, FL 33578
Phone (813) 671-0064

Organizations & group practices 1

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": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1134901465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519A E BLOOMINGDALE AVE STE A",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118105",
            "telephone_number": "813-655-4100",
            "fax_number": "813-655-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519A E BLOOMINGDALE AVE STE A",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118105",
            "telephone_number": "813-655-4100",
            "fax_number": "813-655-1775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13111 US Highway 301 S",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335787401",
            "country_code": "US",
            "telephone_number": "813-671-0064",
            "fax_number": "813-672-2153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARACOSTAS",
        "first_name": "SARA",
        "middle_name": "ROSE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-20",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11024986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.