Individual provider Active NPI

Priscilla Nunes Medeiros, APRN

  • Gerontology Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1609417336
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11004367 Issued in FL
Practice address
601 E Rollins St
Orlando, FL 32803-1248
Phone
(407) 303-7283
Fax
(407) 303-0347
NPI assigned
Oct 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11004367 FL
Adult Health Nurse Practitioner 363LA2200X APRN11004367 FL
Gerontology Nurse Practitioner 363LG0600X APRN11004367 FL Primary

Addresses

Primary practice location

601 E Rollins St
Orlando, FL 32803-1248

Mailing address

2501 N Orange Ave Ste 401
Orlando, FL 32804-4644

Other practice location 1

86 W Underwood St
Orlando, FL 32806-1110
Phone (321) 843-5270

Other practice location 2

540 Tuttle Ct SE
Palm Bay, FL 32909-6682
Phone (321) 960-0258

Other identifiers 1

IdentifierTypeStateIssuer
104804500MedicaidFL

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
I20191209001729 FL Practitioner - Nurse Practitioner 2567895329 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11004367FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Oct 11, 2022 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Apr 13, 2021 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Oct 11, 2022 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Apr 13, 2021 Accepting new patients

Locations

301 Memorial Medical Pkwy
Holly Hill, FL 32117
Phone (386) 231-3906

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

2501 N Orange Ave
Ste 401
Orlando, FL 32804

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

86 Underwood St
Orlando, FL 32806
Phone (321) 841-5142

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: pmedeiros71026@adventhealth.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1609417336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 401",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-303-7283",
            "fax_number": "407-303-0347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "86 W Underwood St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061110",
            "country_code": "US",
            "telephone_number": "321-843-5270",
            "fax_number": "321-843-5177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "540 Tuttle Ct SE",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329096682",
            "country_code": "US",
            "telephone_number": "321-960-0258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDEIROS",
        "first_name": "PRISCILLA",
        "middle_name": "NUNES",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11004367",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11004367",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11004367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104804500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.