Individual provider Active NPI

Jessica Burgan

  • Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1508320458
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11001137 Issued in FL
Practice address
2047 High Ridge Dr
Clearwater, FL 33763-1311
Phone
(727) 612-6637
NPI assigned
Jan 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11001137 FL Primary

Addresses

Primary practice location

2047 High Ridge Dr
Clearwater, FL 33763-1311

Mailing address

2047 High Ridge Dr
Clearwater, FL 33763-1311
Phone (727) 612-6637

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
I20190813001604 FL Practitioner - Nurse Practitioner 6709113822 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Florida College of Medicine, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Pcma Palliative Division LLCGroup PAC ID 1456613637, 72 clinicians

Practice addresses (Care Compare)

4833 Fruitville Rd
Unit 101
Sarasota, FL 34232-1885
Phone (878) 201-3312

Merit-based Incentive Payment System (MIPS)

Final score
57.45 of 100Reported as group
Quality
33.03
Promoting interoperability
0
Improvement activities
40
Cost
75.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11001137FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HCR Manorcare Medical Services of Florida LLC Nurse Practitioner CurrentSince Oct 24, 2020 Accepting new patients

Locations

870 Patricia Ave
Dunedin, FL 34698
Phone (727) 734-8861

8495 Normandy Blvd
Jacksonville, FL 32221
Phone (570) 352-3063

2300 Village Blvd
West Palm Beach, FL 33409
Phone (561) 478-1800

Hcr Manorcare Medical Serv
Columbus, OH 43260

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": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1508320458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2047 HIGH RIDGE DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631311",
            "telephone_number": "727-612-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2047 HIGH RIDGE DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631311",
            "telephone_number": "727-612-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGAN",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11001137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.