Individual provider Active NPI

Cori E Brodsky, ARNP

  • Gerontology Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1265973820
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
9293432 Issued in FL
Practice address
1839 Central Ave
St Petersburg, FL 33713-8900
Phone
(727) 322-1054
Fax
(727) 322-2725
NPI assigned
Mar 15, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9293432 FL
Gerontology Nurse Practitioner 363LG0600X 9293432 FL Primary

Addresses

Primary practice location

1839 Central Ave
St Petersburg, FL 33713-8900

Mailing address

1839 Central Ave
St Petersburg, FL 33713-8900
Phone (727) 322-1054

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
I20170610000046 FL Practitioner - Nurse Practitioner 4981972239 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

148 13TH St SW
Largo, FL 33770-3127
Phone (727) 581-8706

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9293432FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Eye Physicians of Pinellas, PA CurrentSince Jun 18, 2018 Accepting new patients
Professional Health Care of Pinellas Inc. CurrentSince May 16, 2017 Accepting new patients
The Eye Physicians of Pinellas, PA CurrentSince Jun 18, 2018 Accepting new patients
Professional Health Care of Pinellas LLC CurrentSince May 16, 2017 Accepting new patients
The Eye Physicians of Pinellas, PA Past Accepting new patients

Locations

148 13th St SW
Largo, FL 33770
Phone (727) 450-3030

148 13th St SW
Ste 200
Largo, FL 33770
Phone (727) 450-3030

1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054

501 N Howard Ave
Ste 100
Tampa, FL 33606
Phone (813) 253-2727

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA

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, 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": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1265973820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-322-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-322-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODSKY",
        "first_name": "CORI",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9293432",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "9293432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.