Individual provider Active NPI

Tamika Caines

  • Psychiatric/Mental Health Nurse Practitioner
  • Longwood, FL
National Provider Identifier
1255164406
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11034991 Issued in FL
Practice address
455 W Warren Ave
Longwood, FL 32750-4038
Phone
(407) 262-2200
Fax
(407) 834-5011
NPI assigned
Aug 22, 2024
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11034991 FL Primary

Addresses

Primary practice location

455 W Warren Ave
Longwood, FL 32750-4038

Mailing address

455 W Warren Ave
Longwood, FL 32750-4038
Phone (407) 262-2200

Other identifiers 1

IdentifierTypeStateIssuer
124696100MedicaidFL

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
I20241030002962 FL Practitioner - Nurse Practitioner 0749713618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

455 W Warren Ave
Longwood, FL 32750-4038
Phone (407) 262-2220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11034991FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

455 W Warren Ave
Longwood, FL 32750
Phone (407) 260-0551

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1255164406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 W WARREN AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504038",
            "telephone_number": "407-262-2200",
            "fax_number": "407-834-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 W WARREN AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504038",
            "telephone_number": "407-262-2200",
            "fax_number": "407-834-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAINES",
        "first_name": "TAMIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-22",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11034991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124696100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.