Individual provider Active NPI

Susan Maura Scozzafava Mondo, RN, WHNP-BC

  • Women's Health Nurse Practitioner
  • Winter Park, FL
National Provider Identifier
1649811423
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
APRN11004680 Issued in FL
Practice address
100 N Edinburgh Dr Ste 105
Winter Park, FL 32792-4125
Phone
(407) 303-2422
Fax
(407) 303-2435
NPI assigned
Oct 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 217421 NC
Women's Health Nurse Practitioner 363LW0102X MOND-UNSTS9 NC
Women's Health Nurse Practitioner 363LW0102X APRN11004680 FL Primary

Addresses

Primary practice location

100 N Edinburgh Dr Ste 105
Winter Park, FL 32792-4125

Mailing address

100 N Edinburgh Dr Ste 105
Winter Park, FL 32792-4125
Phone (407) 303-2422

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
I20200131001696 FL Practitioner - Nurse Practitioner 7214363720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
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)

2501 N Orange Ave
Orlando, FL 32804-4641

2501 N Orange Ave
Suite 786
Orlando, FL 32804-4651
Phone (407) 303-2422

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

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

631 E Altamonte Dr
Suite 231
Altamonte Springs, FL 32701-4802
Phone (407) 303-5214

894 E Altamonte Dr
Altamonte Springs, FL 32701-5002
Phone (407) 265-6627

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217421NCMDRegistered Nurse
APRN11004680FLMDWomen's Health Nurse Practitioner
MOND-UNSTS9NCMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Feb 17, 2020 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 17, 2020 Accepting new patients

Locations

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

100 N Edinburgh Dr
Ste 105
Winter Park, FL 32792
Phone (407) 303-2422

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: smondo73847@adventhealth.direct-ci.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 4

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": "1579651200000",
    "number": "1649811423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N EDINBURGH DR STE 105",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924125",
            "telephone_number": "407-303-2422",
            "fax_number": "407-303-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N EDINBURGH DR STE 105",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924125",
            "telephone_number": "407-303-2422",
            "fax_number": "407-303-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDO",
        "first_name": "SUSAN",
        "middle_name": "MAURA SCOZZAFAVA",
        "credential": "RN, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "217421",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NC",
            "license": "MOND-UNSTS9",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "APRN11004680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.