Individual provider Active NPI

Nancy Hindalong, APRN

  • Nurse Practitioner
  • Lecanto, FL
National Provider Identifier
1164075560
Registry record updated Nov 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11002197 Issued in FL
Practice address
525 N Dacie PT
Lecanto, FL 34461-8399
Phone
(352) 746-2200
NPI assigned
Jul 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11002197 FL Primary

Addresses

Primary practice location

525 N Dacie PT
Lecanto, FL 34461-8399

Mailing address

4651 Van Dyke Rd
Lutz, FL 33558-4880
Phone (813) 321-1786

Other identifiers 1

IdentifierTypeStateIssuer
106397000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Inverness Direct

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
I20200310000607 FL Practitioner - Nurse Practitioner 7113355934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suncoast Skin SolutionsGroup PAC ID 7416018221, 102 clinicians

Practice addresses (Care Compare)

525 N Dacie PT
Lecanto, FL 34461-8399
Phone (813) 321-1786

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11002197FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Skin Solutions CurrentSince Oct 14, 2022 Accepting new patients
Douglas K Pierce MD PA PastSince Nov 13, 2022 Accepting new patients

Locations

525 N Dacie Pt
Lecanto, FL 34461
Phone (352) 746-2200

4651 Van Dyke Rd
Lutz, FL 33558

9401 SW Highway 200
Ocala, FL 34481
Phone (352) 401-8660

9401 SW Highway 200
Ste 1001
Ocala, FL 34481

3443 Tamiami Trl
Ste 1A
Port Charlotte, FL 33952

25097 Olympia Ave
Ste 202
Punta Gorda, FL 33950
Phone (941) 205-3376

2001 Siesta Dr
Ste 201
Sarasota, FL 34239
Phone (941) 365-5582

5825 US 27 N
Sebring, FL 33870
Phone (863) 314-0001

11200 Seminole Blvd
Ste 205
Seminole, FL 33778
Phone (727) 820-1786

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: nhindalong@suncoastskin.emadirect.md

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": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668211200000",
    "number": "1164075560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584880",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N DACIE PT",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344618399",
            "telephone_number": "352-746-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINDALONG",
        "first_name": "NANCY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2022-11-12",
        "certification_date": "2022-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11002197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106397000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Inverness",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Inverness",
            "address_1": "502 W Highland Blvd",
            "city": "Inverness",
            "state": "FL",
            "country_code": "US",
            "postal_code": "344524720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lecanto, FL

Sources for this page

Verify at the official NPI Registry.