Individual provider Active NPI

Ivonne Pino, APRN

  • Family Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1356802730
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11000700 Issued in FL
Practice address
2701 Park Dr Ste 7
Clearwater, FL 33763-1021
Phone
(888) 707-3436
Fax
(727) 669-7841
NPI assigned
Mar 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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 11000700 FL Primary

Addresses

Primary practice location

2701 Park Dr Ste 7
Clearwater, FL 33763-1021

Mailing address

223 Island Way Apt 3D
Clearwater, FL 33767-2252
Phone (815) 603-8853

Other practice location 1

11300 4th St N
St Petersburg, FL 33716-2918
Phone (888) 707-3436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20221215002967 IL Practitioner - Nurse Practitioner 7911376801 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11000700FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group, PC Family CurrentSince Oct 10, 2022 Accepting new patients

Locations

456 25th Ave
Bellwood, IL 60104
Phone (708) 467-7254

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

Interoperability endpoints

  • Direct secure messaging: ivonne.pino@cinq-nyipa.medentdirect.com
  • Direct secure messaging: ivonne.pino.1@26845.direct.athenahealth.com

Organizations & group practices 2

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1356802730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 ISLAND WAY APT 3D",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337672252",
            "telephone_number": "815-603-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 PARK DR STE 7",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631021",
            "telephone_number": "888-707-3436",
            "fax_number": "727-669-7841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11300 4th St N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337162918",
            "country_code": "US",
            "telephone_number": "888-707-3436",
            "fax_number": "727-669-7841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINO",
        "first_name": "IVONNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11000700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.