Nino Anthony Fajardo, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

11014439 Issued in FL

Practice address

24323 Painter Dr
Land O Lakes, FL 34639-5459

Phone

(863) 409-8812

NPI assigned

Apr 10, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

University Medical Service Association IncGroup PAC ID 6800790221, 818 clinicians

Sage Infusion, LLCGroup PAC ID 1254660467, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tampa General Hospital Hospital, Tampa, FL, CCN 100128

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: nfajardo274229@direct.tgh.org

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.

• Florida Hospital Physician Group Inc

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256
  Medicare reassignment Care Compare group NPD
• Sage Infusion, LLC

  • Infusion Therapy Clinic/Center
  • Tampa, FL
  • NPI 1013578442
  Medicare reassignment Care Compare group NPD
• University Medical Service Association Inc

  • Physical Therapist
  • Tampa, FL
  • NPI 1992742324
  Medicare reassignment Care Compare group NPD
• Florida Kidney Physicians, LLC

  • Nephrology Physician
  • Temple Terrace, FL
  • NPI 1760831564
  Medicare reassignment NPD
• Florida Kidney Physicians , LLC

  • Nephrology Physician
  • Melbourne, FL
  • NPI 1205506722
  NPD
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• University Medical Service Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Tampa, FL
  • NPI 1194276576
  NPD
• University Medical Service Association Inc

  • General Practice Physician
  • Tampa, FL
  • NPI 1326088295
  NPD
• University Medical Service Association Inc

  • Neurological Surgery Physician
  • Tampa, FL
  • NPI 1740227966
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Florida Health Sciences Center Inc

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1235196510
  Care Compare affiliation

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

{
    "created_epoch": "1649548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1174265268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "813-821-8038",
            "fax_number": "813-974-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24323 PAINTER DR",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346395459",
            "telephone_number": "863-409-8812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063571",
            "country_code": "US",
            "telephone_number": "813-821-8038",
            "fax_number": "813-974-0483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "NINO ANTHONY",
        "name_prefix": "Mr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-10",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11014439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2B2SJ",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114149900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nfajardo274229@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shelly Lynn Evans, D.C.
• Excellence in Home Health Services LLC
• Eye Works of Land O' Lakes
• Sharie M Fabregas, PSY.D
• Lori Ann Fagan
• Family Dental at Connerton
• Michael Oneal Farrow II
• Samar Fathalla
• Reema Joseph Felix, PMHNP-BC
• Juana R Feliz, DDS

• Acute Care Nurse Practitioner in Land O Lakes, FL
• Providers in Land O Lakes, FL by specialty
• Acute Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.