Individual provider Active NPI

Raji Kuriakose

  • Family Nurse Practitioner
  • Valrico, FL
National Provider Identifier
1215301031
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9288938 Issued in FL
Practice address
436 Country Vineyard Dr
Valrico, FL 33594-3045
Phone
(813) 850-3004
NPI assigned
Nov 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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 9288938 FL Primary

Addresses

Primary practice location

436 Country Vineyard Dr
Valrico, FL 33594-3045

Mailing address

436 Country Vineyard Dr
Valrico, FL 33594-3045
Phone (813) 850-3004

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
I20240125001731 FL Practitioner - Nurse Practitioner 8022461177

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9288938FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Urgent Care Associates LLC PastSince Apr 6, 2023 Accepting new patients

Interoperability endpoints

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

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": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1215301031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 COUNTRY VINEYARD DR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335943045",
            "telephone_number": "813-850-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 COUNTRY VINEYARD DR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335943045",
            "telephone_number": "813-850-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURIAKOSE",
        "first_name": "RAJI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2024-02-14",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9288938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valrico, FL

Sources for this page

Verify at the official NPI Registry.