Individual provider Active NPI

Maryana Henson, ARNP

  • Nurse Practitioner
  • Largo, FL
National Provider Identifier
1417331273
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9308838 Issued in FL
Practice address
3600 Oak Manor LN Apt 46
Largo, FL 33774-1214
Phone
(727) 489-3305
Fax
(727) 499-9559
NPI assigned
Jul 11, 2015
Last updated
Apr 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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 ARNP9308838 FL Primary

Addresses

Primary practice location

3600 Oak Manor LN Apt 46
Largo, FL 33774-1214

Mailing address

3600 Oak Manor LN. #46
Largo, FL 33774
Phone (727) 504-2792

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
I20150915002973 FL Practitioner - Nurse Practitioner 1153638606 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Value Based Long Term Care F PCGroup PAC ID 2769922731, 18 clinicians
Legacy Health Medical Group, LLCGroup PAC ID 5193962173, 17 clinicians

Practice addresses (Care Compare)

801 W Bay Dr
Suite 605
Largo, FL 33770-3268
Phone (727) 489-3305

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9308838FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Value Based Long Term Care F PC CurrentSince Apr 19, 2025 Accepting new patients
Careconnectmd Florida P.a. CurrentSince Aug 1, 2024 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

5 Research Dr
Shelton, CT 06484
Phone (203) 567-5264

801 West Bay Dr
Ste 605
Largo, FL 33770
Phone (727) 489-3305

Organizations & group practices 3

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 4

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": "1436572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1417331273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 OAK MANOR LN. #46",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "33774",
            "telephone_number": "727-504-2792",
            "fax_number": "727-499-9559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 OAK MANOR LN APT 46",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337741214",
            "telephone_number": "727-489-3305",
            "fax_number": "727-499-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "MARYANA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-11",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9308838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.