Individual provider Active NPI

Alyssa L Macca, APRN

  • Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1346317047
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9204843 Issued in FL
Practice address
5140 Highlands by the Lake Dr
Lakeland, FL 33812-3083
Phone
(863) 640-8500
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9204843 FL Primary

Addresses

Primary practice location

5140 Highlands by the Lake Dr
Lakeland, FL 33812-3083

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other identifiers 8

IdentifierTypeStateIssuer
01904OtherFLUNIVERSAL
301304OtherFLAVMED
200731387OtherFLTRICARE
37919ZOtherFLBCBS PROVIDER #
Y12VVOtherFLBCBS
200731387OtherFLHUMANA
269836600MedicaidFL
U7175XOtherMEDICARE PTAN

Other names 1

  • Miss Alyssa Nicole Liguori Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amacca144926@direct.tgh.org

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
I20060328000366 FL Practitioner - Nurse Practitioner 7517975873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1324 Lakeland Hill Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1100

4202 E Fowler Ave
Tampa, FL 33620-6750

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc CurrentSince Apr 24, 2018 Accepting new patients
University Medical Service Association Inc CurrentSince Apr 24, 2018 Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: amacca144926@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 6

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 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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1346317047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 HIGHLANDS BY THE LAKE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338123083",
            "telephone_number": "863-640-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCA",
        "first_name": "ALYSSA",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9204843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSAL",
            "identifier": "01904",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "301304",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "200731387",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "37919Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y12VV",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "200731387",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269836600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "U7175X",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amacca144926@direct.tgh.org",
            "affiliation": "N",
            "address_1": "5140 Highlands By The Lake Dr",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338123083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "LIGUORI",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.