Individual provider Active NPI

Dara Bornstein Trafka, CNM

  • Advanced Practice Midwife
  • Orlando, FL
National Provider Identifier
1164061156
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
APRN11005908 Issued in FL
Practice address
1116 Lucerne Ter
Orlando, FL 32806-1017
Phone
(407) 316-8550
Fax
(407) 316-8311
NPI assigned
Dec 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X APRN11005908 FL Primary
Women's Health Nurse Practitioner 363LW0102X APRN11005908 FL

Addresses

Primary practice location

1116 Lucerne Ter
Orlando, FL 32806-1017

Mailing address

PO Box 748817
Atlanta, GA 30374-8817
Phone (813) 286-0033

Other practice location 1

4761 S Cleveland Ave
Fort Myers, FL 33907-1375
Phone (239) 343-6100

Other practice location 2

15901 Bass Rd Ste 100
Fort Myers, FL 33908-3838
Phone (239) 343-6100

Other identifiers 1

IdentifierTypeStateIssuer
105413500MedicaidFL

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200602002847 FL Practitioner - Certified Nurse Midwife (CNM) 1658792403 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
APRN11005908FLMDWomen's Health Nurse Practitioner

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": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1164061156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 LUCERNE TER",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061017",
            "telephone_number": "407-316-8550",
            "fax_number": "407-316-8311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4761 S Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339071375",
            "country_code": "US",
            "telephone_number": "239-343-6100",
            "fax_number": "239-343-9727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15901 Bass Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339083838",
            "country_code": "US",
            "telephone_number": "239-343-6100",
            "fax_number": "239-343-9925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAFKA",
        "first_name": "DARA",
        "middle_name": "BORNSTEIN",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-23",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "APRN11005908",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "APRN11005908",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105413500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.