Individual provider Active NPI

Jismi Cyriac

  • Family Nurse Practitioner
  • Seffner, FL
National Provider Identifier
1386428845
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11028173 Issued in FL
Practice address
309 Harts Oak PL
Seffner, FL 33584-4769
Phone
(813) 481-9704
NPI assigned
Aug 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11028173 FL Primary

Addresses

Primary practice location

309 Harts Oak PL
Seffner, FL 33584-4769

Mailing address

309 Harts Oak PL
Seffner, FL 33584-4769
Phone (813) 481-9704

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
I20250213001924 FL Practitioner - Nurse Practitioner 2769912278 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ibrahim Heart Clinic PLLCGroup PAC ID 4688958648, 43 clinicians

Practice addresses (Care Compare)

5150 Belfort Rd
BLDG 400
Jacksonville, FL 32256-6026
Phone (904) 580-4730

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11028173FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Care Gastroenterology Associates CurrentSince Apr 10, 2025 Accepting new patients
Ibrahim Heart Clinic PLLC CurrentSince Feb 1, 2025 Accepting new patients

Locations

215 S US Highway 17
East Palatka, FL 32131
Phone (386) 232-9203

213 S US Highway 17
Ste A
East Palatka, FL 32131
Phone (786) 589-7248

1590 Island Ln
Ste 73
Fleming Island, FL 32003

5150 Belfort Rd
Bldg 400
Jacksonville, FL 32256
Phone (904) 296-0900

319 W Call St
Ste B
Starke, FL 32091
Phone (904) 368-9102

15303 Amberly Dr
Ste A
Tampa, FL 33647
Phone (813) 712-5700

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1386428845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 HARTS OAK PL",
            "city": "SEFFNER",
            "state": "FL",
            "postal_code": "335844769",
            "telephone_number": "813-481-9704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 HARTS OAK PL",
            "city": "SEFFNER",
            "state": "FL",
            "postal_code": "335844769",
            "telephone_number": "813-481-9704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYRIAC",
        "first_name": "JISMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11028173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seffner, FL

Sources for this page

Verify at the official NPI Registry.