Individual provider Active NPI

Sirirat Poontreeratn, APRN

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1316518640
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11013679 Issued in FL
Practice address
3701 Avalon Park West Blvd Ste 205
Orlando, FL 32828-4809
Phone
(407) 306-0982
Fax
(407) 384-7754
NPI assigned
Jul 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11013679 FL Primary

Addresses

Primary practice location

3701 Avalon Park West Blvd Ste 205
Orlando, FL 32828-4809

Mailing address

250 Harrison St
Titusville, FL 32780-5094
Phone (321) 268-6868

Other practice location 1

250 Harrison St
Titusville, FL 32780-5094
Phone (321) 268-6868

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
I20211019001562 FL Practitioner - Nurse Practitioner 2264820588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3701 Avalon Park W Blvd
Suite 205
Orlando, FL 32828-4809

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Jul 17, 2023 Accepting new patients
Florida Hospital Medical Group Inc Family Medicine CurrentSince Jul 17, 2023 Accepting new patients
Adventhealth Primary Care Network Inc Family Medicine CurrentSince Nov 1, 2023 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

3701 Avalon Park West Blvd
Ste 205
Orlando, FL 32828
Phone (407) 303-6285

Interoperability endpoints

  • Direct secure messaging: spoontreeratn414195@adventhealth.direct-ci.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 2

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": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1316518640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HARRISON ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327805094",
            "telephone_number": "321-268-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 AVALON PARK WEST BLVD STE 205",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284809",
            "telephone_number": "407-306-0982",
            "fax_number": "407-384-7754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Harrison St",
            "address_purpose": "LOCATION",
            "city": "Titusville",
            "state": "FL",
            "postal_code": "327805094",
            "country_code": "US",
            "telephone_number": "321-268-6868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POONTREERATN",
        "first_name": "SIRIRAT",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11013679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.