Individual provider Active NPI

Nicole Maria Rosenthal, ACNPC-AG

  • Adult Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1366950685
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN9174987 Issued in FL
Practice address
3000 Medical Park Dr Ste 300
Tampa, FL 33613
NPI assigned
Jan 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN9174987 FL Primary

Addresses

Primary practice location

3000 Medical Park Dr Ste 300
Tampa, FL 33613

Mailing address

3000 Medical Park Dr Ste 300
Tampa, FL 33613-4696
Phone (813) 615-8088

Other identifiers 1

IdentifierTypeStateIssuer
14195803OtherCAQH

Other names 1

  • Miss Nicole Maria Payne Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, DE, NY, CT4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20190208002992 FL Practitioner - Nurse Practitioner 5496000754 Reassigns benefits to 4 organizations
I20230822002933 DE Practitioner - Nurse Practitioner 5496000754 Reassigns benefits to 1 organization
I20231208001273 NY Practitioner - Nurse Practitioner 5496000754 Reassigns benefits to 1 organization
I20240109002329 CT Practitioner - Nurse Practitioner 5496000754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin Memorial Medical Center IncGroup PAC ID 2961300611, 514 clinicians

Practice addresses (Care Compare)

10000 SW Innovation Way
Port Saint Lucie, FL 34987-2111
Phone (772) 345-8100

Hospital & facility affiliations

  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044
  • Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12570CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Florida IV, LLC CurrentSince Nov 11, 2019 Accepting new patients
Hospitalist Medicine Physicians of Delaware, PA CurrentSince Jun 2, 2023 Accepting new patients
Martin Memorial Medical Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Florida Hospital Physician Group Inc CurrentSince Dec 20, 2018 Accepting new patients
Hospitalist Medicine Physicians of Connecticut - TCS CurrentSince Nov 27, 2023 Accepting new patients
Cogent Healthcare of Jacksonville, LLC CurrentSince Nov 11, 2019 Accepting new patients
Critical Care Physician of New York PC CurrentSince Nov 29, 2023 Accepting new patients
Sound Physicians of Florida IV, LLC CurrentSince Nov 11, 2019 Accepting new patients
Cogent Healthcare of Jacksonville, LLC CurrentSince Nov 11, 2019 Accepting new patients

Locations

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

640 S State St
Dover, DE 19901
Phone (302) 744-4700

701 N Clayton St
Wilmington, DE 19805
Phone (302) 421-4100

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

10000 SW Innovation Way
Port St Lucie, FL 34987
Phone (772) 288-5853

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

509 SE Riverside Dr
Ste 305
Stuart, FL 34994
Phone (772) 221-2003

3100 E Fletcher Ave
#C
Tampa, FL 33613

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

3000 Medical Park Dr
Ste 300
Tampa, FL 33613
Phone (813) 497-9661

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

12 N 7th Ave
Mount Vernon, NY 10550
Phone (914) 361-6511

70 Dubois St
Fl 2
Newburgh, NY 12550
Phone (845) 561-4400

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 9

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": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1366950685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL PARK DR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134696",
            "telephone_number": "813-615-8088",
            "fax_number": "813-615-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL PARK DR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENTHAL",
        "first_name": "NICOLE",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-22",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9174987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14195803",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "PAYNE",
            "middle_name": "MARIA",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.