Individual provider Active NPI

Marlana Disanto, NP

  • Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1366494122
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9165818 Issued in FL
Practice address
5151 N 9TH Ave Ste 200
Pensacola, FL 32504-8721
Phone
(850) 416-4970
Fax
(850) 419-4969
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9165818 FL Primary
Acute Care Nurse Practitioner 363LA2100X 9165818 FL

Addresses

Primary practice location

5151 N 9TH Ave Ste 200
Pensacola, FL 32504-8721

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623

Other identifiers 2

IdentifierTypeStateIssuer
140011MedicaidAL
307062000MedicaidFL

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
I20060110000191 FL Practitioner - Nurse Practitioner 3476576026 Reassigns benefits to 1 organization

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
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

5151 N 9TH Ave
Suite 200
Pensacola, FL 32504-8721
Phone (850) 416-4188

Hospital & facility affiliations

  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
  • Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9165818FLMDNurse Practitioner
9165818FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. Current Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Sep 1, 2019 Accepting new patients
Sacred Heart Health System Inc CurrentSince Sep 1, 2019 Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

5151 N 9th Ave
Ste 200
Pensacola, FL 32504
Phone (850) 416-4188

4501 N Davis Hwy
Ste A
Pensacola, FL 32503
Phone (850) 476-9000

8333 N Davis Hwy
Fl 4
Pensacola, FL 32514
Phone (850) 474-8610

Interoperability endpoints

  • Direct secure messaging: marlana.disanto.1@9582.direct.athenahealth.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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1366494122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 N 9TH AVE STE 200",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048721",
            "telephone_number": "850-416-4970",
            "fax_number": "850-419-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISANTO",
        "first_name": "MARLANA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9165818",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "9165818",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140011",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307062000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.