Individual provider Active NPI

Daria Christine Dzembo, ARNP

  • Nurse Practitioner
  • St. Petersburg, FL
National Provider Identifier
1407871312
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP2903832 Issued in FL
Practice address
10000 Bay Pines Blvd
St. Petersburg, FL 33708
Phone
(727) 398-6661
Fax
(727) 319-1252
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP2903832 FL Primary

Addresses

Primary practice location

10000 Bay Pines Blvd
St. Petersburg, FL 33708

Mailing address

PO Box 5005
Bay Pines, FL 33744-5005
Phone (727) 398-6661

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
I20080910000152 FL Practitioner - Nurse Practitioner 3476629700 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Health Care of Pinellas Inc. CurrentSince Aug 31, 2015 Accepting new patients
Professional Health Care of Pinellas LLC CurrentSince Aug 31, 2015 Accepting new patients
Advanced Lung and Sleep Disorders Consultants P a PastSince Jan 1, 2008 Accepting new patients
West Central Gastroenterology LLP Past Accepting new patients

Locations

1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA

Organizations & group practices 4

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1407871312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5005",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "337445005",
            "telephone_number": "727-398-6661",
            "fax_number": "727-319-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33708",
            "telephone_number": "727-398-6661",
            "fax_number": "727-319-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZEMBO",
        "first_name": "DARIA",
        "middle_name": "CHRISTINE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-11-01",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2903832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Petersburg, FL

Sources for this page

Verify at the official NPI Registry.