Venture Medical of Florida LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

VENTURE MEDICAL OF FLORIDA LLC

Practice address

430 8TH Ave W
Palmetto, FL 34221-5120

Phone

(941) 544-0366

Fax

(941) 212-6059

NPI assigned

Dec 12, 2017

Organization subpart

No

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

Authorized official

Name

Alexander N Petreas, PA

Title

Member

Phone

(941) 400-7051

Specialties & licenses 4

Addresses

Other names 2

• Bayshore Urgent Care Services Doing business as
• Ellenton Urgent Care Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Heisey, ARNP-CNP

  • Family Nurse Practitioner
  • Tampa, FL
  • NPI 1093172272
  Medicare reassignment
• Ian M. Kahane, M.D.

  • Internal Medicine Physician
  • Bradenton, FL
  • NPI 1861846263
  Medicare reassignment
• Christina Marie Mehriary, MD

  • Family Medicine Physician
  • Sarasota, FL
  • NPI 1699812057
  Medicare reassignment
• Tracey Griffin Warner, ARNP

  • Family Nurse Practitioner
  • Bradenton, FL
  • NPI 1396294971
  Medicare reassignment
• Cory Taraska

  • Physician Assistant
  • Palmetto, FL
  • NPI 1861251605
  NPD
• Elizabeth I Young, BSN, CWS

  • Wound Care Registered Nurse
  • Bradenton, FL
  • NPI 1841985215
  NPD

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1366957482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7206 16TH AVE NW",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342091151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 8TH AVE W",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342215120",
            "telephone_number": "941-544-0366",
            "fax_number": "941-212-6059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 53rd Ave E",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342034706",
            "country_code": "US",
            "telephone_number": "941-909-7900",
            "fax_number": "941-538-5015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VENTURE MEDICAL OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-12",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "PETREAS",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "941-400-7051",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayshore Urgent Care Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ellenton Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trinity Senior Care Group, Inc.
• Nhi My Truong, CRNP, CPNP-PC
• Nelexis Urbaneja
• VA Care Wave Inc
• Keith Jon Van Leuven, LMHC
• Vertical Chiropractic of Florida, PLLC
• Vida Plena Home Care LLC
• Cristina Villalon, SLP
• Kasandra Rose Villalon, M.S. CCC-SLP
• Visiting Physicians of South Florida

• General Practice Physician in Palmetto, FL
• Providers in Palmetto, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.