Elisa Rosario Icaza, ARNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

APRN1701762 Issued in FL

Practice address

1700 66TH St. N.
Suite 510
St. Petersburg, FL 33710-5512

Phone

(727) 384-2479

Fax

(727) 384-3573

NPI assigned

May 24, 2006

Sex

Female

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 1

Other names 1

• Elisa Rosario Icaza Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BJGBAA

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.

• Advanced Bay Area Medical Associates

  • Infectious Disease Physician
  • St Petersburg, FL
  • NPI 1700965050
  Medicare reassignment NPD

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1194770271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 66TH ST. N.",
            "address_2": "SUITE 510",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337105512",
            "telephone_number": "727-384-2479",
            "fax_number": "727-384-3573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 66TH ST. N.",
            "address_2": "SUITE 510",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337105512",
            "telephone_number": "727-384-2479",
            "fax_number": "727-384-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICAZA",
        "first_name": "ELISA",
        "middle_name": "ROSARIO",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN1701762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304992200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISA",
            "last_name": "ICAZA",
            "middle_name": "ROSARIO",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marina Ibrahim
• Omar Ibrahim, MD
• Silvia S Ibrahim
• Scheber Ibreus
• Icare Homecare LLC
• Suzanne T Icely, M.D.
• Icm Associates, Inc.
• Chris Dimitrios Idaris, CPNP-AC
• Idongesit Silas Idiong, PHARM.D
• Malaz Idris

• Primary Care Nurse Practitioner in St. Petersburg, FL
• Providers in St. Petersburg, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.