Individual provider Active NPI

Elena Samigulina, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dania Beach, FL
National Provider Identifier
1649098641
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11036100 Issued in FL
Practice address
500 NE 2ND St Apt 407
Dania Beach, FL 33004-3375
Phone
(786) 532-3337
NPI assigned
Sep 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11036100 FL Primary

Addresses

Primary practice location

500 NE 2ND St Apt 407
Dania Beach, FL 33004-3375

Mailing address

500 NE 2ND St Apt 407
Dania Beach, FL 33004-3375
Phone (786) 532-3337

Other practice location 1

4700 N Habana Ave Ste 601
Tampa, FL 33614-7160
Phone (832) 869-4818

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
I20241204001687 FL Practitioner - Nurse Practitioner 5496281255 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Learning to Achieve Wellness IncGroup PAC ID 9234514464, 48 clinicians
Psychiatry of Texas PLLCGroup PAC ID 0345573598, 418 clinicians

Practice addresses (Care Compare)

413 W Robertson St
Suite B
Brandon, FL 33511-5014
Phone (813) 999-1516

4700 N Habana Ave
Suite 601
Tampa, FL 33614-7160
Phone 8328694818235

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Learning to Achieve Wellness Inc Psychiatric/Mental Health CurrentSince Sep 1, 2025 Accepting new patients
Psychplus Medical Associates, PLLC CurrentSince Mar 15, 2025 Accepting new patients
Psychiatry of Texas PLLC Psychiatric/Mental Health CurrentSince Nov 27, 2024 Accepting new patients

Locations

250 2nd St E
Ste 4C
Bradenton, FL 34208
Phone (941) 744-5860

413 W Robertson St
Ste B
Brandon, FL 33511
Phone (813) 657-4711

6700 Winkler Rd
Ste 4
Fort Myers, FL 33919
Phone 8328694818 ext. 235

5995 SE Community Dr
Stuart, FL 34997
Phone (727) 424-3427

4700 N Habana Ave
Ste 601
Tampa, FL 33614
Phone (201) 706-1143

7877 Willow Chase Blvd
Houston, TX 77070
Phone 8328694818109

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, 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": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1649098641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE 2ND ST APT 407",
            "city": "DANIA BEACH",
            "state": "FL",
            "postal_code": "330043375",
            "telephone_number": "786-532-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NE 2ND ST APT 407",
            "city": "DANIA BEACH",
            "state": "FL",
            "postal_code": "330043375",
            "telephone_number": "786-532-3337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 N Habana Ave Ste 601",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336147160",
            "country_code": "US",
            "telephone_number": "832-869-4818",
            "fax_number": "832-241-2902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMIGULINA",
        "first_name": "ELENA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11036100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dania Beach, FL

Sources for this page

Verify at the official NPI Registry.