Pegah Yaghoubi Yeganeh

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9333392 Issued in FL

Practice address

12280 Lake Underhill Rd
Orlando, FL 32825-5009

Phone

(866) 389-2727

NPI assigned

Jul 24, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: pegah.yaghoubiyeganeh@552337174953988.direct.elationemr.com

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1518444397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 BOUGIVAL CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288223",
            "telephone_number": "321-230-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12280 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328255009",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5058 Conway Rd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328121258",
            "country_code": "US",
            "telephone_number": "239-533-5700",
            "fax_number": "844-465-0860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7710 NW 71st Ct Ste 205",
            "address_purpose": "LOCATION",
            "city": "Tamarac",
            "state": "FL",
            "postal_code": "333212931",
            "country_code": "US",
            "telephone_number": "239-533-5700",
            "fax_number": "844-465-0860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8039 Cooper Creek Blvd Ste 106",
            "address_purpose": "LOCATION",
            "city": "University Park",
            "state": "FL",
            "postal_code": "342013007",
            "country_code": "US",
            "telephone_number": "239-533-5700",
            "fax_number": "844-465-0860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 Davis Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341044370",
            "country_code": "US",
            "telephone_number": "239-533-5700",
            "fax_number": "844-465-0860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5111 Ehrlich Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336242075",
            "country_code": "US",
            "telephone_number": "239-533-5700",
            "fax_number": "844-465-0860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11300 Lindbergh Blvd Ste 107A",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339138827",
            "country_code": "US",
            "telephone_number": "239-533-5700",
            "fax_number": "844-465-0860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6500 S Dixie Hwy Ste C",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334054416",
            "country_code": "US",
            "telephone_number": "239-533-5700",
            "fax_number": "844-865-0860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAGHOUBI YEGANEH",
        "first_name": "PEGAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "FL",
            "license": "RN9333392",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9333392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lucas Yamashiro

• Family Nurse Practitioner in Orlando, FL
• Providers in Orlando, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.