Individual provider Active NPI

Elimerys Mora Machado, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1427828599
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11030305 Issued in FL
Practice address
15503 Bear Creek Dr
Tampa, FL 33624-1701
Phone
(813) 585-6894
NPI assigned
Jan 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11030305 FL Primary

Addresses

Primary practice location

15503 Bear Creek Dr
Tampa, FL 33624-1701

Mailing address

15503 Bear Creek Dr
Tampa, FL 33624-1701
Phone (813) 585-6894

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
I20240307000541 FL Practitioner - Nurse Practitioner 9335585876 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11030305FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mana Health Partners PA CurrentSince Feb 3, 2024 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

991 Pondella Rd
North Ft Myers, FL 33903
Phone (239) 994-8809

1317 Edgewater Dr
Orlando, FL 32804
Phone (877) 436-8527

3825 Countryside Blvd N
Palm Harbor, FL 34684
Phone (727) 781-1402

1507 S Tuttle Ave
Sarasota, FL 34239
Phone (941) 366-0336

338 Whitesville Rd
Ste 103
Jackson, NJ 08527

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1427828599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15503 BEAR CREEK DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241701",
            "telephone_number": "813-585-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15503 BEAR CREEK DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241701",
            "telephone_number": "813-585-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA MACHADO",
        "first_name": "ELIMERYS",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11030305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.