Ellen L Larusso, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9428863 Issued in FL

Practice address

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167

Phone

(386) 231-3615

Fax

(386) 231-3614

NPI assigned

May 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiorenal Therapeutics LLCGroup PAC ID 7416280425, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Cardiorenal Therapeutics LLC

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1457917304
  Medicare reassignment Care Compare group NPD
• Nautilus Health Care Group LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Melbourne, FL
  • NPI 1912013558
  Medicare reassignment NPD
• Nautilus Health Care Group, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Kokomo, IN
  • NPI 1013234699
  NPD
• Advanced Wound Systems LLC

  • Durable Medical Equipment & Medical Supplies
  • St Petersburg, FL
  • NPI 1508054271
  NPD (past)

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1427263383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 BELFORT RD STE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566017",
            "telephone_number": "904-446-3424",
            "fax_number": "904-443-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MEMORIAL MEDICAL PKWY",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175167",
            "telephone_number": "386-231-3615",
            "fax_number": "386-231-3614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "736 Irving Avenue",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "13210",
            "country_code": "US",
            "telephone_number": "315-410-7111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1540 Sunday Dr",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276076010",
            "country_code": "US",
            "telephone_number": "919-782-3456",
            "fax_number": "919-783-1441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARUSSO",
        "first_name": "ELLEN",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F335300-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009587",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9428863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lee Lanni, APRN
• Jiana Sunday Lanza, DC
• Diane F Lapham, MD
• Christine Lapila
• Hae S Larens
• Lashawnacaregiverservices
• Zafar Latif, M.D.
• Brianna Nichole Latorre
• Annie Lau, D.O.
• Erika Lau, AUD

• Family Nurse Practitioner in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.