Individual provider Active NPI

Jose O Serrano Rosa, MS, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1477106870
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11034902 Issued in FL
Practice address
8431 W Linebaugh Ave
Tampa, FL 33625-3729
Phone
(813) 993-1375
Fax
(813) 990-0222
NPI assigned
Jul 24, 2019
Reactivated
Oct 2, 2024
Last updated
Nov 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 005303 PR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F406295-01 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11034902 FL Primary
Registered Nurse 163W00000X 90073 PR
Registered Nurse 163W00000X RN9597608 FL
Registered Nurse 163W00000X 804384 NY

Addresses

Primary practice location

8431 W Linebaugh Ave
Tampa, FL 33625-3729

Mailing address

3443 Gentry Cir
Spring Hill, FL 34608-7279

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
I20241129000523 FL Practitioner - Nurse Practitioner 2567997471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Psychiatric Health IncGroup PAC ID 7810290384, 26 clinicians

Practice addresses (Care Compare)

27716 Cashford Cir
Suite 101
Wesley Chapel, FL 33544-6962
Phone (813) 540-1466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9597608FLMDRegistered Nurse
804384NYMDRegistered Nurse
90073PRMDRegistered Nurse
APRN11034902FLMDPsychiatric/Mental Health Nurse Practitioner
F406295-01NYMDPsychiatric/Mental Health Nurse Practitioner
005303PRMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Psychiatric Health Inc CurrentSince Nov 14, 2024 Accepting new patients
Partners in Medicine & Surgery, P.a. PastSince Nov 14, 2024 Accepting new patients

Locations

8431 W Linebaugh Ave
Tampa, FL 33625
Phone (813) 792-5730

27716 Cashford Cir
Ste 101
Wesley Chapel, FL 33544
Phone (813) 540-1466

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1477106870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3443 GENTRY CIR",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346087279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8431 W LINEBAUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336253729",
            "telephone_number": "813-993-1375",
            "fax_number": "813-990-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO ROSA",
        "first_name": "JOSE",
        "middle_name": "O",
        "credential": "MS, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-24",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "deactivation_date": "2024-03-23",
        "reactivation_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PR",
            "license": "005303",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F406295-01",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11034902",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PR",
            "license": "90073",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9597608",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "804384",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.