Individual provider Active NPI

Rasha Botros, FNP

  • Family Nurse Practitioner
  • Daytona Beach, FL
National Provider Identifier
1598351835
Registry record updated Dec 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11010717 Issued in FL
Practice address
810 Wildwood St
Daytona Beach, FL 32117-4568
Phone
(386) 258-7100
NPI assigned
Dec 20, 2020
Last updated
Dec 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11010717 FL Primary

Addresses

Primary practice location

810 Wildwood St
Daytona Beach, FL 32117-4568

Mailing address

1806 Creekwater Blvd
Port Orange, FL 32128-4088
Phone (386) 383-9546

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL downloads Direct

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
I20210121001813 FL Practitioner - Nurse Practitioner 9032523618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sleep-Wake Disorder Center of Daytona PAGroup PAC ID 4789832916, 3 clinicians

Practice addresses (Care Compare)

810 Wildwood St
Suite 1
Daytona Beach, FL 32117-4568
Phone (386) 258-7100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11010717FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep-Wake Disorder Center of Daytona PA CurrentSince Jan 15, 2021 Accepting new patients

Locations

810 Wildwood St
Daytona Beach, FL 32117
Phone (386) 257-2363

810 Wildwood St
#1
Daytona Beach, FL 32117
Phone (386) 258-7100

4869 Palm Coast Pkwy NW
Unit 45
Palm Coast, FL 32137
Phone (386) 258-7100

Organizations & group practices 1

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": "1608422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608422400000",
    "number": "1598351835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 CREEKWATER BLVD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321284088",
            "telephone_number": "386-383-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 WILDWOOD ST",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174568",
            "telephone_number": "386-258-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTROS",
        "first_name": "RASHA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-20",
        "last_updated": "2020-12-20",
        "certification_date": "2020-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11010717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "downloads",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "810 Wildwood St",
            "city": "Daytona Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321174568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.