Individual provider Active NPI

Sunnye Deidre Lee Macca

  • Family Nurse Practitioner
  • Zephyrhills, FL
National Provider Identifier
1629699509
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11004950 Issued in FL
Practice address
36763 Eiland Blvd Ste 102
Zephyrhills, FL 33542-0600
Phone
(813) 778-0454
Fax
(813) 377-1699
NPI assigned
May 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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 11004950 FL Primary

Addresses

Primary practice location

36763 Eiland Blvd Ste 102
Zephyrhills, FL 33542-0600

Mailing address

38135 Market SQ
Zephyrhills, FL 33542-7505
Phone (352) 567-0188

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
I20210810003916 FL Practitioner - Nurse Practitioner 1153725353 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

13417 US Hwy 301
Dade City, FL 33525-5446

17470 Brookside Trace CT
Tampa, FL 33647-6201
Phone (813) 443-5042

36763 Eiland Blvd
Zephyrhills, FL 33542-0600

36819 Eiland Blvd
Suite 101
Zephyrhills, FL 33542-0600
Phone (813) 778-0408

38051 Market Square Dr
Zephyrhills, FL 33542-7504

38101 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 715-0195

38103 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 778-0414

38105 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 815-5380

38107 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 979-0440

38135 Market Square Dr
Zephyrhills, FL 33542-7505

Hospital & facility affiliations

  • Concierge Home Care Home health agency, Odessa, FL, CCN 108428
  • Adventhealth Home Health Home health agency, Dade City, FL, CCN 108170
  • Adventhealth Zephyrhills Hospital, Zephyrhills, FL, CCN 100046

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11004950FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Clinic LLC CurrentSince Sep 6, 2021 Accepting new patients
Ohi West Medical Group II LLC CurrentSince Apr 1, 2024 Accepting new patients
Ohi West Medical Group II LLC CurrentSince Apr 1, 2024 Accepting new patients
Florida Medical Clinic, LLC CurrentSince Sep 6, 2021 Accepting new patients
Ohi West Medical Group II LLC Past Accepting new patients

Locations

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

36763 Eiland Blvd
Ste 102
Zephyrhills, FL 33542
Phone (813) 778-0454

Organizations & group practices 5

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 3

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": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1629699509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188",
            "fax_number": "813-355-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36763 EILAND BLVD STE 102",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335420600",
            "telephone_number": "813-778-0454",
            "fax_number": "813-377-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCA",
        "first_name": "SUNNYE",
        "middle_name": "DEIDRE LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-01",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11004950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.