Gisselle Van Etten

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11015464 Issued in FL

Practice address

530 Spring Leap Cir
Winter Garden, FL 34787-5298

Phone

(407) 988-9393

NPI assigned

Sep 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, TN, VA3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Psynergy Health Med PLLCGroup PAC ID 0749714707, 35 clinicians

Lakota Wellness LLCGroup PAC ID 9234277203, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Psynergy Health Med PLLC

  • Primary Care Clinic/Center
  • Orlando, FL
  • NPI 1891513420

  TN, VA

  Medicare reassignment Care Compare group NPD
• Lakota Wellness, LLC

  • Family Medicine Physician
  • Ocoee, FL
  • NPI 1396070041
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1632009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632009600000",
    "number": "1235809476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 SPRING LEAP CIR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875298",
            "telephone_number": "407-988-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 SPRING LEAP CIR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875298",
            "telephone_number": "407-988-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ETTEN",
        "first_name": "GISSELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-19",
        "last_updated": "2021-09-19",
        "certification_date": "2021-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11015464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Upperline Healthcare, PC
• Lacie A Uppole, APRN
• Tomas Urbanik
• Carlos Valderrama
• Carolina Valenzuela- Childs, COTA
• Vishwas Vanar, MD
• Diane Geralyn Vanbuskirk, OTR/L
• Claudia Vargas
• Pablo Jesus Vargas, DPT
• Sonia Merle Vassell, M.A

• Family Nurse Practitioner in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.