Individual provider Active NPI

Lisa M Gavosto, APRN

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1174853923
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9190830 Issued in FL
Practice address
3000 Medical Park Dr
Suite 150
Tampa, FL 33613-4680
Phone
(813) 977-2020
Fax
(813) 355-5010
NPI assigned
Dec 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP9190830 FL
Family Nurse Practitioner 363LF0000X APRN9190830 FL
Nurse Practitioner 363L00000X APRN9190830 FL Primary

Addresses

Primary practice location

3000 Medical Park Dr
Suite 150
Tampa, FL 33613-4680

Mailing address

38135 Market SQ
Zephyrhills, FL 33542-7505
Phone (813) 528-4975

Other identifiers 1

IdentifierTypeStateIssuer
P01191553OtherFLR&R MEDICARE

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
I20111116000259 FL Practitioner - Nurse Practitioner 6406020064 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Practice addresses (Care Compare)

38101 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 715-0195

38103 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 778-0414

38105 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 815-5380

38107 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 979-0440

38135 Market Square Dr
Zephyrhills, FL 33542-7505

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9190830FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohi West Medical Group II LLC CurrentSince Apr 1, 2024 Accepting new patients
Florida Medical Clinic, LLC CurrentSince Apr 1, 2013 Accepting new patients
Ohi West Medical Group II LLC CurrentSince Apr 1, 2024 Accepting new patients
Florida Medical Clinic LLC CurrentSince Apr 1, 2013 Accepting new patients
Diabetes & Hormonal Diseases Center PLC Past Accepting new patients
Ohi West Medical Group II LLC Past Accepting new patients

Locations

14014 N 46th St
Ste B
Tampa, FL 33613
Phone (813) 782-3727

3000 Medical Park Dr
Ste 150
Tampa, FL 33613
Phone (813) 977-2020

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1174853923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "813-528-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL PARK DR",
            "address_2": "SUITE 150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134680",
            "telephone_number": "813-977-2020",
            "fax_number": "813-355-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVOSTO",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-29",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9190830",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9190830",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9190830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R&R MEDICARE",
            "identifier": "P01191553",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.