Individual provider Active NPI

Yaischa C Dukes

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1194277459
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP 9308356 Issued in FL
Practice address
5130 Sunforest Dr
Tampa, FL 33634-6318
Phone
(657) 400-5180
NPI assigned
Nov 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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 ARNP 9308356 FL Primary

Addresses

Primary practice location

5130 Sunforest Dr
Tampa, FL 33634-6318

Mailing address

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone (386) 226-4590

Other practice location 1

1101 N Lake Destiny Rd
Ste 300
Maitland, FL 32751-7114
Phone (407) 900-0390

Other identifiers 1

IdentifierTypeStateIssuer
ARNP 9308356OtherFLSTATE LICENSE

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
I20170406001658 FL Practitioner - Nurse Practitioner 5799061768 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 9308356FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Coast Bariatrics, Inc. CurrentSince Dec 12, 2016 Accepting new patients
Halifax Healthcare Systems Inc CurrentSince Jul 23, 2018 Accepting new patients

Locations

303 N Clyde Morris Blvd
Fl First
Daytona Beach, FL 32114
Phone (386) 425-6198

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

707 Platinum Pt
Lake Mary, FL 32746
Phone (386) 481-6774

Interoperability endpoints

  • Direct secure messaging: ms_ydukes2@landmarkhealth-direct.org

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": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1194277459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-226-4590",
            "fax_number": "386-226-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 SUNFOREST DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346318",
            "telephone_number": "657-400-5180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 N Lake Destiny Rd",
            "address_2": "STE 300",
            "address_purpose": "LOCATION",
            "city": "Maitland",
            "state": "FL",
            "postal_code": "327517114",
            "country_code": "US",
            "telephone_number": "407-900-0390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUKES",
        "first_name": "YAISCHA",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-02",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 9308356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ARNP 9308356",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.