Individual provider Active NPI

Elisa J. Thompson, M.D.

  • Family Medicine Physician
  • Spring Hill, FL
National Provider Identifier
1255375689
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME125969 Issued in FL
Practice address
120 Medical Blvd Ste 103
Spring Hill, FL 34609-0221
Phone
(352) 340-2115
Fax
(352) 340-2116
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16013 ME
Family Medicine Physician 207Q00000X ME125969 FL Primary

Addresses

Primary practice location

120 Medical Blvd Ste 103
Spring Hill, FL 34609-0221

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other identifiers 2

IdentifierTypeStateIssuer
P00245819OtherMERAILROAD MEDICARE
255720099MedicaidME

Other names 1

  • Elisa T. Ruksznis Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170124000267 FL Practitioner - Family Practice 1557336849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Geisel School of Medicine at Dartmouth, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

120 Medical Blvd
Spring Hill, FL 34609-0220
Phone (352) 340-2115

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

2675 Winkler Ave
Fort Myers, FL 33901-9328

2675 Winkler Avenue
Suite 200
Fort Myers, FL 33901-9328

Hospital & facility affiliations

  • Visiting Nurse Association of Florida Inc Home health agency, Weeki Wachee, FL, CCN 107609
  • Pinnacle Home Care of Spring Hill Inc Home health agency, Spring Hill, FL, CCN 108068
  • Concierge Home Care Home health agency, Spring Hill, FL, CCN 108223
  • Enhabit Home Health Home health agency, Brooksville, FL, CCN 108449
  • HCA Florida Oak Hill Hospital Hospital, Brooksville, FL, CCN 100264
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
  • Adventhealth Wesley Chapel Hospital, Wesley Chapel, FL, CCN 100319
  • Adventhealth Dade City Hospital, Dade City, FL, CCN 100211
  • H Lee Moffitt Cancer Center & Research Institute I Hospital, Tampa, FL, CCN 100271
  • Encompass Health Rehab Hospital of Spring Hill Inpatient rehabilitation facility, Brooksville, FL, CCN 103042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME125969FLMDFamily Medicine Physician
16013MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc Family Medicine CurrentSince Nov 28, 2016 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Apr 2, 2024 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Apr 2, 2024 Accepting new patients

Locations

14540 Cortez Blvd
Ste 102
Brooksville, FL 34613
Phone (352) 596-7255

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

18923 State Road 54
Lutz, FL 33558
Phone (813) 803-7150

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

120 Medical Blvd
Ste 103
Spring Hill, FL 34609
Phone (352) 340-2115

120 Medical Blvd
Spring Hill, FL 34609
Phone (352) 340-2115

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

Interoperability endpoints

  • Direct secure messaging: elisa.thompson.1@4290.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1255375689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MEDICAL BLVD STE 103",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346090221",
            "telephone_number": "352-340-2115",
            "fax_number": "352-340-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ELISA",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "16013",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME125969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00245819",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255720099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISA",
            "last_name": "RUKSZNIS",
            "middle_name": "T.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spring Hill, FL

Sources for this page

Verify at the official NPI Registry.