Individual provider Active NPI

Jezlyn Vargas-Villa, APRN

  • Family Nurse Practitioner
  • Oviedo, FL
National Provider Identifier
1184393258
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11015335 Issued in FL
Practice address
2871 Clayton Crossing Way Ste 1049
Oviedo, FL 32765-3426
Phone
(407) 602-3916
NPI assigned
Sep 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11015335 FL Primary

Addresses

Primary practice location

2871 Clayton Crossing Way Ste 1049
Oviedo, FL 32765-3426

Mailing address

2871 Clayton Crossing Way Ste 1049
Oviedo, FL 32765-3426
Phone (407) 602-3916

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
I20220208002216 FL Practitioner - Nurse Practitioner 3678966017 Reassigns benefits to 1 organization

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
Phoenix Integrated Medical CenterGroup PAC ID 1759718737, 3 clinicians

Practice addresses (Care Compare)

1936 Lee Rd
Suite 137
Winter Park, FL 32789-7201
Phone (407) 637-8300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Integrated Medical Center Nurse Practitioner CurrentSince Jul 13, 2024 Accepting new patients

Locations

1936 Lee Rd
Ste 137
Winter Park, FL 32789
Phone (407) 637-8300

Organizations & group practices 1

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": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1184393258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2871 CLAYTON CROSSING WAY STE 1049",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327653426",
            "telephone_number": "407-602-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2871 CLAYTON CROSSING WAY STE 1049",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327653426",
            "telephone_number": "407-602-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS-VILLA",
        "first_name": "JEZLYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11015335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

Verify at the official NPI Registry.