Individual provider Active NPI

Mirka M Elosegui, APRN

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1346948700
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11023862 Issued in FL
Practice address
5611 Sheldon Rd
Tampa, FL 33615-3532
Phone
(813) 397-5300
Fax
(813) 738-9012
NPI assigned
Feb 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 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 11023862 FL Primary

Addresses

Primary practice location

5611 Sheldon Rd
Tampa, FL 33615-3532

Mailing address

PO Box 82969
Tampa, FL 33682-2969
Phone (823) 866-0930

Other practice location 1

6616 Memorial Hwy # 6616
Tampa, FL 33615-4502
Phone (813) 475-9362

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
I20230509003111 FL Practitioner - Nurse Practitioner 5698131019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa Family Health Centers IncGroup PAC ID 1254243769, 66 clinicians

Practice addresses (Care Compare)

5611 Sheldon Rd
Tampa, FL 33615-3532
Phone (813) 397-5300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11023862FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Family Health Centers Inc Current Accepting new patients
Tampa Family Health Centers, Inc CurrentSince May 8, 2023 Accepting new patients
Tampa Family Health Centers, Inc. CurrentSince May 8, 2023 Accepting new patients

Locations

5611 Sheldon Rd
Tampa, FL 33615
Phone (813) 397-5320

302 W Fletcher Ave
Tampa, FL 33612

7814 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 405-3939

8213 W Waters Ave
Tampa, FL 33615
Phone (813) 490-5420

12410 N Nebraska Ave
Tampa, FL 33612

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.

NPI Registry JSON

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

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1346948700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82969",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336822969",
            "telephone_number": "823-866-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5611 SHELDON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336153532",
            "telephone_number": "813-397-5300",
            "fax_number": "813-738-9012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6616 Memorial Hwy # 6616",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336154502",
            "country_code": "US",
            "telephone_number": "813-475-9362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELOSEGUI",
        "first_name": "MIRKA",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11023862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.