Individual provider Active NPI

Ismara Hernandez Carrazana, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1487264917
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11008176 Issued in FL
Practice address
3645 W Waters Ave
Tampa, FL 33614-2783
Phone
(813) 462-2595
Fax
(813) 462-2596
NPI assigned
Aug 10, 2020
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11008176 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11008176 FL Primary

Addresses

Primary practice location

3645 W Waters Ave
Tampa, FL 33614-2783

Mailing address

3645 W Waters Ave
Tampa, FL 33614-2783
Phone (813) 462-2595

Other practice location 1

4311 W Waters Ave Ste 304B
Tampa, FL 33614-1901
Phone (813) 400-2201

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
I20201116001551 FL Practitioner - Nurse Practitioner 6608287024 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psych Me Health Services IncGroup PAC ID 1951769041, 4 clinicians

Practice addresses (Care Compare)

4311 W Waters Ave
Suite 304
Tampa, FL 33614-2194
Phone (813) 400-2201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Medical Centers Corp CurrentSince Oct 14, 2020 Accepting new patients
Psych Me Health Services Inc CurrentSince Apr 26, 2023 Accepting new patients

Locations

1140 S Semoran Blvd
Ste C
Orlando, FL 32807
Phone (407) 271-8990

3645 W Waters Ave
Tampa, FL 33614
Phone (813) 462-2595

4311 W Waters Ave
Ste 304
Tampa, FL 33614
Phone (813) 400-2201

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19420/brand/1/csg/1/fhir/r4

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": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1487264917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 W WATERS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142783",
            "telephone_number": "813-462-2595",
            "fax_number": "813-462-2596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 W WATERS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142783",
            "telephone_number": "813-462-2595",
            "fax_number": "813-462-2596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 W Waters Ave Ste 304B",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336141901",
            "country_code": "US",
            "telephone_number": "813-400-2201",
            "fax_number": "813-212-5230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ CARRAZANA",
        "first_name": "ISMARA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008176",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11008176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.