Susan Irene Borgiasz

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN9474864 Issued in FL

Practice address

2424 Manatee Ave W Ste 100
Bradenton, FL 34205-4954

Phone

(941) 847-7920

Fax

(941) 757-2291

NPI assigned

Mar 8, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Susan Irene Banaszak Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Corrective Care Chiropractic Limited Liability Company

  • Chiropractor
  • Bradenton, FL
  • NPI 1245426733
  NPD (past)
• Optumcare Florida Ci, LLC

  • Primary Care Clinic/Center
  • Winter Park, FL
  • NPI 1720506603
  NPD (past)
• Medexpress, Inc - Delaware

  • Family Medicine Physician
  • Wilmington, DE
  • NPI 1255692182
  NPD (past)
• Medexpress, Inc - Delaware

  • Family Medicine Physician
  • Dover, DE
  • NPI 1265770135
  NPD (past)

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1275994071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 SUNFOREST DR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346327",
            "telephone_number": "727-824-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 MANATEE AVE W STE 100",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342054954",
            "telephone_number": "941-847-7920",
            "fax_number": "941-757-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGIASZ",
        "first_name": "SUSAN",
        "middle_name": "IRENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173210",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9474864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "BANASZAK",
            "middle_name": "IRENE",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Debra Lynn Bonine, MA
• Adrienne Sue Bookhamer, LCSW
• Alayna Marie Bootsma, LMHC
• Scott Borbely
• Natalie Elizabeth Borg, DO
• Angela Ann Bose, CRNA
• Ciara Bostock, MOT, OTRL
• Rafik Botros
• Amir Mohamed Boubekri, MD
• Kyle Boudreaux

• Family Nurse Practitioner in Bradenton, FL
• Providers in Bradenton, 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 Dec 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.