Individual provider Active NPI

Carmel Portillo Alamban, APRN

  • Nurse Practitioner
  • Temple Terrace, FL
National Provider Identifier
1366808602
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9215128 Issued in FL
Practice address
13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926
Phone
(813) 779-6303
Fax
(888) 977-1998
NPI assigned
Dec 31, 2015
Last updated
Nov 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN9215128 FL
Nurse Practitioner 363L00000X APRN9215128 FL Primary

Addresses

Primary practice location

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926

Mailing address

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926
Phone (813) 779-6303

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
I20171121002996 FL Practitioner - Nurse Practitioner 9335444827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pioneer Medical Group PLGroup PAC ID 8224266655, 68 clinicians

Practice addresses (Care Compare)

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926
Phone (813) 779-6303

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9215128FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Medical Group, PL Nurse Practitioner CurrentSince Oct 1, 2017 Accepting new patients

Locations

515 Chesapeake Dr
Tarpon Springs, FL 34689
Phone (727) 934-4629

13067 N Telecom Pkwy
Temple Terrace, FL 33637
Phone (813) 333-9108

26844 Tanic Dr
Ste 101
Wesley Chapel, FL 33544

38250 A Ave
Zephyrhills, FL 33542
Phone (813) 732-5608

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1451520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1366808602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13067 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370926",
            "telephone_number": "813-779-6303",
            "fax_number": "888-977-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13067 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370926",
            "telephone_number": "813-779-6303",
            "fax_number": "888-977-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAMBAN",
        "first_name": "CARMEL",
        "middle_name": "PORTILLO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-31",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9215128",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9215128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.