Individual provider Active NPI

Marie V Pirillo-Collins, APRN

  • Nurse Practitioner
  • Lutz, FL
National Provider Identifier
1396011813
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9268967 Issued in FL
Practice address
17621 Ledger Line LN
Lutz, FL 33558-5621
Phone
(386) 864-1641
NPI assigned
Mar 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP-9268967 FL
Nurse Practitioner 363L00000X APRN9268967 FL Primary

Addresses

Primary practice location

17621 Ledger Line LN
Lutz, FL 33558-5621

Mailing address

17621 Ledger Line LN
Lutz, FL 33558-5621
Phone (386) 864-1641

Other practice location 1

5421 Beaumont Center Blvd
Tampa, FL 33634-5259
Phone (786) 644-6413

Other identifiers 1

IdentifierTypeStateIssuer
1396011813OtherFLNPI

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
I20120516000157 FL Practitioner - Nurse Practitioner 3274796958 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9268967FLMDNurse Practitioner
ARNP-9268967FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dispatchhealth-Florida Inc. PastSince Aug 1, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ms_mpirillo@landmarkhealth-direct.org
  • Direct secure messaging: marie.collins.1@13869.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1396011813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17621 LEDGER LINE LN",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585621",
            "telephone_number": "386-864-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17621 LEDGER LINE LN",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585621",
            "telephone_number": "386-864-1641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5421 Beaumont Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336345259",
            "country_code": "US",
            "telephone_number": "786-644-6413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIRILLO-COLLINS",
        "first_name": "MARIE",
        "middle_name": "V",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP-9268967",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9268967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1396011813",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.