Individual provider Active NPI

Faith Select Zolfaghari

  • Family Nurse Practitioner
  • Casselberry, FL
National Provider Identifier
1386269017
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11007314 Issued in FL
Practice address
1120 State Road 436 Ste 1600
Casselberry, FL 32707-6182
Phone
(407) 322-8645
Fax
(407) 269-8986
NPI assigned
Jun 9, 2020
Last updated
Nov 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9365224 FL
Family Nurse Practitioner 363LF0000X 11007314 FL Primary

Addresses

Primary practice location

1120 State Road 436 Ste 1600
Casselberry, FL 32707-6182

Mailing address

4930 E Lake Mary Blvd
Sanford, FL 32771-5003
Phone (407) 322-8645

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
I20201113000576 FL Practitioner - Nurse Practitioner 4587074919 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

4660 13TH St
Saint Cloud, FL 34769-6765
Phone (407) 200-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9365224FLMDRegistered Nurse
11007314FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System/Sunbelt, Inc Family CurrentSince Feb 8, 2023 Accepting new patients
Adventist Health System Sunbelt, Inc. Family Current Accepting new patients
Adventist Health System/Sunbelt, Inc. Family CurrentSince Feb 8, 2023 Accepting new patients
Adventist Health System/ Sunbelt, Inc. Family CurrentSince Feb 20, 2023 Accepting new patients
Adventist Health System Sunbelt Inc Family Current Accepting new patients
Adventist Health System/Sunbelt, Inc. Family CurrentSince Feb 20, 2023 Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

4660 13th St
Saint Cloud, FL 34769
Phone (321) 805-4650

Interoperability endpoints

  • Direct secure messaging: fzolfaghari1496372@adventhealth.direct-ci.com

Organizations & group practices 6

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.

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": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1386269017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 E LAKE MARY BLVD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327715003",
            "telephone_number": "407-322-8645",
            "fax_number": "407-269-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 STATE ROAD 436 STE 1600",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327076182",
            "telephone_number": "407-322-8645",
            "fax_number": "407-269-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLFAGHARI",
        "first_name": "FAITH",
        "middle_name": "SELECT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9365224",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casselberry, FL

Sources for this page

Verify at the official NPI Registry.