Individual provider Active NPI

Elizabeth Mae Di Martino, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tarpon Springs, FL
National Provider Identifier
1184373391
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11018644 Issued in FL
Practice address
354 Tall Oak TRL
Tarpon Springs, FL 34688-7711
Phone
(304) 942-1466
NPI assigned
Mar 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11018644 FL Primary

Addresses

Primary practice location

354 Tall Oak TRL
Tarpon Springs, FL 34688-7711

Mailing address

354 Tall Oak TRL
Tarpon Springs, FL 34688-7711
Phone (130) 494-2146

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL N/A 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
I20220929002271 FL Practitioner - Nurse Practitioner 1456737345 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michelle R Scargle MD PAGroup PAC ID 9436217841, 6 clinicians

Practice addresses (Care Compare)

2454 N McMullen Booth Rd
Suite 502
Clearwater, FL 33759-1340
Phone (727) 265-8770

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michelle R Scargle MD PA CurrentSince Jan 17, 2024 Accepting new patients
Ashit K Vijapura MD PA CurrentSince Sep 1, 2022 Accepting new patients

Locations

2454 N McMullen Booth Rd
Ste 502
Clearwater, FL 33759
Phone (727) 265-8770

802 W Dr Martin Luther King Jr Blvd
Ste D
Plant City, FL 33563
Phone (813) 707-9101

Organizations & group practices 3

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": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1184373391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 TALL OAK TRL",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346887711",
            "telephone_number": "130-494-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 TALL OAK TRL",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346887711",
            "telephone_number": "304-942-1466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DI MARTINO",
        "first_name": "ELIZABETH",
        "middle_name": "MAE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11018644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "354 Tall Oak Trl",
            "city": "Tarpon Springs",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346887711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tarpon Springs, FL

Sources for this page

Verify at the official NPI Registry.