NPIMap

Individual provider Active NPI

Alecksandra Pantoja, APRN

  • Gerontology Nurse Practitioner
  • High Springs, FL
National Provider Identifier
1609508027
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11020437 Issued in FL
Practice address
7400 NE 24TH Loop
High Springs, FL 32643-6208
Phone
(352) 215-5494
NPI assigned
Jun 24, 2022
Last updated
Jun 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN11020437 FL Primary

Addresses

Primary practice location

7400 NE 24TH Loop
High Springs, FL 32643-6208

Mailing address

7400 NE 24TH Loop
High Springs, FL 32643-6208
Phone (352) 215-5494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220801002847 FL Practitioner - Nurse Practitioner 2062894421 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
Telehealth
Offers telehealth services
Group practices
My Choice Operating Company LLCGroup PAC ID 3779991542, 60 clinicians

Practice addresses (Care Compare)

4655 Salisbury Rd
Suite 220
Jacksonville, FL 32256-0959
Phone (904) 570-9404

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
My Choice Operating Company LLC CurrentSince May 31, 2022 Accepting new patients

Locations

4655 Salisbury Rd
Ste 110
Jacksonville, FL 32256
Phone (904) 570-9404

4655 Salisbury Rd
Ste 220
Jacksonville, FL 32256
Phone (904) 570-9404

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1609508027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 NE 24TH LOOP",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "326436208",
            "telephone_number": "352-215-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 NE 24TH LOOP",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "326436208",
            "telephone_number": "352-215-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTOJA",
        "first_name": "ALECKSANDRA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11020437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Springs, FL

Sources for this page

Verify at the official NPI Registry.