Individual provider Active NPI

Rebecca Kraft, NP-C

  • Gerontology Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1215331871
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
9287987 Issued in FL
Practice address
3665 Madaca LN
Tampa, FL 33618-2048
Phone
(813) 280-7380
Fax
(813) 355-5039
NPI assigned
Oct 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 9287987 FL Primary

Addresses

Primary practice location

3665 Madaca LN
Tampa, FL 33618-2048

Mailing address

38135 Market SQ
Zephyrhills, FL 33542-7505
Phone (813) 528-4975

Other identifiers 1

IdentifierTypeStateIssuer
014234800MedicaidFL

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
I20150610001741 FL Practitioner - Nurse Practitioner 8022339480 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Practice addresses (Care Compare)

3665 Madaca LN
Tampa, FL 33618-2048
Phone (813) 280-7380

38101 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 715-0195

38103 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 778-0414

38105 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 815-5380

38107 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 979-0440

38135 Market Square Dr
Zephyrhills, FL 33542-7505

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9287987FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohi West Medical Group II LLC CurrentSince Apr 1, 2024 Accepting new patients
Florida Medical Clinic LLC CurrentSince Mar 8, 2016 Accepting new patients
Ohi West Medical Group II LLC CurrentSince Apr 1, 2024 Accepting new patients
Florida Medical Clinic, LLC CurrentSince Mar 8, 2016 Accepting new patients
Ohi West Medical Group II LLC Past Accepting new patients

Locations

3665 Madaca Ln
Tampa, FL 33618
Phone (813) 280-7380

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 5

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": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1215331871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "813-528-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3665 MADACA LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182048",
            "telephone_number": "813-280-7380",
            "fax_number": "813-355-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAFT",
        "first_name": "REBECCA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-10",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "9287987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014234800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.