Gregory Rafael Disla, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11003473 Issued in FL

Practice address

216 S Seminole Ave
Inverness, FL 34452-4738

Phone

(352) 560-0333

Fax

(813) 931-1427

NPI assigned

Jul 26, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Mar Primary Care LLCGroup PAC ID 8325383052, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Beverly Hills, FL, CCN 107684
• Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
• HCA Florida Citrus Hospital Hospital, Inverness, FL, CCN 100023

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19044/brand/3/csg/1/fhir/r4
• Direct secure messaging: gregory.disla.1@19044.direct.athenahealth.com

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.

• Mar Primary Care LLC

  • Primary Care Clinic/Center
  • Tampa, FL
  • NPI 1417423344
  Medicare reassignment Care Compare group NPD
• Mar Primary Care LLC

  • Internal Medicine Physician
  • Inverness, FL
  • NPI 1659049732
  NPD
• Minuteclinic LLC

  • Family Nurse Practitioner
  • Rockville, MD
  • NPI 1134191836
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Citrus Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Inverness, FL
  • NPI 1750780342
  Care Compare affiliation
• Senior Home Care, Inc.

  • Home Health Agency
  • Beverly Hills, FL
  • NPI 1699726620
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Boynton Beach, FL
  • NPI 1467507657
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Miami Lakes, FL
  • NPI 1528113792
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Melbourne, FL
  • NPI 1669548053
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Tallahassee, FL
  • NPI 1972555464
  Care Compare affiliation

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1376197541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 US HIGHWAY 301 S",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335783800",
            "telephone_number": "813-740-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 S SEMINOLE AVE",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524738",
            "telephone_number": "352-560-0333",
            "fax_number": "813-931-1427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5905 US Highway 301 S",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335783800",
            "country_code": "US",
            "telephone_number": "813-740-8463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2901 W Saint Isabel St Ste F",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076371",
            "country_code": "US",
            "telephone_number": "813-935-4744",
            "fax_number": "813-931-1427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DISLA",
        "first_name": "GREGORY",
        "middle_name": "RAFAEL",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-26",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11003473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Inverness, FL
• Providers in Inverness, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.