Individual provider Active NPI

Liberty Sagucio Pagayon, DNAP APRN

  • Certified Registered Nurse Anesthetist
  • Lake Mary, FL
National Provider Identifier
1285218636
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11013160 Issued in FL
Practice address
716 Hupa CT
Lake Mary, FL 32746-2210
Phone
(914) 498-4001
NPI assigned
May 11, 2021
Last updated
Jul 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN11013160 FL Primary

Addresses

Primary practice location

716 Hupa CT
Lake Mary, FL 32746-2210

Mailing address

716 Hupa CT
Lake Mary, FL 32746-2210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210712000958 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517369747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

1401 S Seminole Blvd
Sanford, FL 32771-6743
Phone (407) 321-4500

4500 W Newberry Rd
Gainesville, FL 32607-2245
Phone (352) 367-2310

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
APRN11013160FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc Anesthesiology CurrentSince Jun 1, 2021 Accepting new patients
Sheridan Healthcorp, Inc. Anesthesiology CurrentSince Jun 1, 2021 Accepting new patients
Sheridan Healthcorp Inc Anesthesiology Current Accepting new patients

Locations

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

2275 N Central Ave
Kissimmee, FL 34741
Phone (407) 570-0573

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

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

Hospital & facility affiliations 1

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": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1285218636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 HUPA CT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 HUPA CT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462210",
            "telephone_number": "914-498-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGAYON",
        "first_name": "LIBERTY",
        "middle_name": "SAGUCIO",
        "credential": "DNAP APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11013160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.