Individual provider Active NPI

Consuelo Tomas

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1497590103
Registry record updated Dec 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11033619 Issued in FL
Practice address
4190 Belfort Rd Ste 140
Jacksonville, FL 32216-5871
Phone
(904) 296-2999
NPI assigned
Jun 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11033619 FL Primary

Addresses

Primary practice location

4190 Belfort Rd Ste 140
Jacksonville, FL 32216-5871

Mailing address

13453 N Main St Ste 104
Jacksonville, FL 32218-2773

Other practice location 1

13453 N Main St Ste 104
Jacksonville, FL 32218-2773
Phone (323) 781-7957

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
I20241126001855 FL Practitioner - Nurse Practitioner 5991230054 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11033619FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Discovery Mental Health Services Psychiatric/Mental Health CurrentSince Oct 21, 2024 Accepting new patients
Carlos Torrellas MD, LLC Psychiatric/Mental Health PastSince Jan 1, 2025 Accepting new patients

Locations

13453 N Main St
Ste 104
Jacksonville, FL 32218
Phone (904) 773-4390

Interoperability endpoints

  • Direct secure messaging: consuelo.tomas.1@19860.direct.athenahealth.com

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": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734134400000",
    "number": "1497590103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13453 N MAIN ST STE 104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322182773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 BELFORT RD STE 140",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165871",
            "telephone_number": "904-296-2999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13453 N Main St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322182773",
            "country_code": "US",
            "telephone_number": "323-781-7957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMAS",
        "first_name": "CONSUELO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-12-14",
        "certification_date": "2024-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11033619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.