Individual provider Active NPI

Natacha M Nicholas

  • Psychiatric/Mental Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1265171367
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11019930 Issued in FL
Practice address
422 S Alafaya TRL
Orlando, FL 32828-8984
Phone
(407) 456-4688
NPI assigned
May 27, 2022
Last updated
May 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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 11019930 FL Primary

Addresses

Primary practice location

422 S Alafaya TRL
Orlando, FL 32828-8984

Mailing address

2345 Upland LN
Apopka, FL 32712-6507
Phone (407) 456-4688

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
I20230825003560 FL Practitioner - Nurse Practitioner 5193188985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2910 Maguire Rd
Suite 2002
Ocoee, FL 34761-4742
Phone (407) 287-1664

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.02
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11019930FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC CurrentSince Aug 1, 2023 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Aug 1, 2023 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

2910 Maguire Rd
Ste 2002
Ocoee, FL 34761
Phone (407) 287-1664

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

Interoperability endpoints

  • Direct secure messaging: natacha.nicholas.1@13142.direct.athenahealth.com

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": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1265171367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 UPLAND LN",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327126507",
            "telephone_number": "407-456-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 S ALAFAYA TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288984",
            "telephone_number": "407-456-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "NATACHA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11019930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.