Individual provider Active NPI

Mary Antoinette Evangelista Guerra, APRN

  • Certified Registered Nurse Anesthetist
  • Orlando, FL
National Provider Identifier
1477209666
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11032794 Issued in FL
Practice address
62 Columbia St
Orlando, FL 32806-1115
Phone
(407) 514-3668
Fax
(321) 843-2196
NPI assigned
Feb 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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 RN9485827 FL
Certified Registered Nurse Anesthetist 367500000X APRN11032794 FL Primary

Addresses

Primary practice location

62 Columbia St
Orlando, FL 32806-1115

Mailing address

62 Columbia St
Orlando, FL 32806-1115
Phone (407) 514-3668

Other practice location 1

1415 Sligh Blvd
Orlando, FL 32806-3954
Phone (407) 497-0435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240814002513 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901344522 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

62 Columbia St
Orlando, FL 32806-1115
Phone (321) 843-5851

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9485827FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Physician Solutions of North Florida, LLC CurrentSince Aug 1, 2024 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jun 6, 2024 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2024 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jun 6, 2024 Accepting new patients
Anesthesiologists of Greater Orlando Inc Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2024 Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2024 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Anesthesiologists of Greater Orlando Inc Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2024 Accepting new patients

Locations

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553

380 Rinehart Rd
Lake Mary, FL 32746
Phone (321) 842-0550

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

62 Columbia St
Orlando, FL 32806
Phone (321) 214-4903

83 W Miller St
Orlando, FL 32806
Phone (321) 841-5281

22 Underwood St
Orlando, FL 32806
Phone (321) 841-6263

52 Underwood St
Orlando, FL 32806
Phone (321) 841-3581

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

8300 Red Bug Lake Rd
Oviedo, FL 32765
Phone (407) 359-6007

325 Cypress Pkwy
Poinciana, FL 34759
Phone (407) 530-2000

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1477209666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061115",
            "telephone_number": "407-514-3668",
            "fax_number": "321-843-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061115",
            "telephone_number": "407-514-3668",
            "fax_number": "321-843-2196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Sligh Blvd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328063954",
            "country_code": "US",
            "telephone_number": "407-497-0435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "MARY ANTOINETTE",
        "middle_name": "EVANGELISTA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9485827",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11032794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.