Individual provider Active NPI

Eleanor Emong Manera, NURSE PRACTITIONER

  • Acute Care Nurse Practitioner
  • Largo, FL
National Provider Identifier
1477197861
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
11004868 Issued in FL
Practice address
10774 125TH Ave
Largo, FL 33778-2712
Phone
(727) 412-4898
NPI assigned
Oct 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 11004868 FL Primary

Addresses

Primary practice location

10774 125TH Ave
Largo, FL 33778-2712

Mailing address

10774 125TH Ave
Largo, FL 33778-2712
Phone (727) 412-4898

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
I20241118002883 FL Practitioner - Nurse Practitioner 8628503315 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11004868FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP CurrentSince Nov 1, 2024 Accepting new patients
Eduardo Palanca MD PA CurrentSince Sep 17, 2024 Accepting new patients
Labella Home, LLC CurrentSince Feb 6, 2022 Accepting new patients

Locations

549 Sky Harbor Dr
Bldg 31
Clearwater, FL 33759
Phone (727) 724-6800

1840 Mease Dr
Ste 315
Safety Harbor, FL 34695
Phone (727) 631-1592

2901 Rigsby Ln
Safety Harbor, FL 34695
Phone (727) 218-8870

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (410) 967-2097

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1477197861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10774 125TH AVE",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337782712",
            "telephone_number": "727-412-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10774 125TH AVE",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337782712",
            "telephone_number": "727-412-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANERA",
        "first_name": "ELEANOR",
        "middle_name": "EMONG",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11004868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.