Individual provider Active NPI

Nasser Nasralla, ARNP

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1417444019
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9352697 Issued in FL
Practice address
2450 N Orange Blossom TRL
Kissimmee, FL 34744-2316
Phone
(321) 297-0740
NPI assigned
Apr 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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 9352697 FL
Family Nurse Practitioner 363LF0000X ARNP9352697 FL Primary

Addresses

Primary practice location

2450 N Orange Blossom TRL
Kissimmee, FL 34744-2316

Mailing address

1925 Peridot Cir
Kissimmee, FL 34743-3716
Phone (321) 297-0740

Other identifiers 1

IdentifierTypeStateIssuer
1417444019MedicaidFL

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
I20190212001351 FL Practitioner - Nurse Practitioner 0840538138 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Care Specialists LLCGroup PAC ID 0345493623, 101 clinicians
Central Florida Inpatient Medicine LLCGroup PAC ID 7911805254, 113 clinicians

Practice addresses (Care Compare)

525 Technology Park
Suite 109
Lake Mary, FL 32746-7107
Phone 4076472346111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9352697FLMDRegistered Nurse
ARNP9352697FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Healthcare Systems Inc CurrentSince Aug 31, 2021 Accepting new patients
Central Florida Inpatient Medicine LLC CurrentSince May 1, 2022 Accepting new patients
Cardiac Clinic of Sunil M. Kakkar, M.D, P.a CurrentSince Mar 1, 2019 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

303 N Clyde Morris Blvd
Fl First
Daytona Beach, FL 32114
Phone (386) 425-6198

3300 E Halifax Crossing Blvd
Deltona, FL 32725
Phone (386) 425-1800

311 W Oak St
Kissimmee, FL 34741
Phone (407) 933-1423

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

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, 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": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1417444019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 PERIDOT CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347433716",
            "telephone_number": "321-297-0740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 N ORANGE BLOSSOM TRL",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347442316",
            "telephone_number": "321-297-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASRALLA",
        "first_name": "NASSER",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9352697",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9352697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417444019",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.