Individual provider Active NPI

Rudina X. Priska, MD

  • Family Medicine Physician
  • Winter Park, FL
National Provider Identifier
1639373962
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME116286 Issued in FL
Practice address
2304 Aloma Ave Ste 100
Winter Park, FL 32792-3330
Phone
(407) 679-9222
Fax
(407) 679-9061
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME116286 FL Primary

Addresses

Primary practice location

2304 Aloma Ave Ste 100
Winter Park, FL 32792-3330

Mailing address

5130 Sunforest Dr Ste 300
Tampa, FL 33634-6327
Phone (727) 824-0780

Other identifiers 1

IdentifierTypeStateIssuer
ME 116286OtherFLMEDICAL LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131014000782 FL Practitioner - Family Practice 9234220104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Johns Hopkins University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

1345 W Bay Dr
202 Optum Largo
Largo, FL 33770-2276
Phone (727) 559-0895

2304 Aloma Ave
Suite 100
Winter Park, FL 32792-3330
Phone (407) 679-9222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME116286FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida LLC Family Medicine CurrentSince Jul 1, 2017 Accepting new patients
Optumcare Florida, LLC CurrentSince Jul 1, 2017 Accepting new patients

Locations

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

10051 5th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 286-4093

5130 Sunforest Dr
Ste 300
Tampa, FL 33634
Phone (813) 302-5835

2304 Aloma Ave
Ste 100
Winter Park, FL 32792
Phone (407) 679-9222

2304 Aloma Ave
Winter Park, FL 32792
Phone (407) 673-2222

Interoperability endpoints

  • Direct secure messaging: rudina.priska@wellmed.eclinicaldirectplus.com

Organizations & group practices 2

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": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1639373962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 SUNFOREST DR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346327",
            "telephone_number": "727-824-0780",
            "fax_number": "727-568-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 ALOMA AVE STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923330",
            "telephone_number": "407-679-9222",
            "fax_number": "407-679-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRISKA",
        "first_name": "RUDINA",
        "middle_name": "X.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2023-03-07",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME116286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME 116286",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.