Individual provider Active NPI

Oriberto Iparraguirre Gongora, NP

  • Family Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1649888769
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11007994 Issued in FL
Practice address
623 Barkfield Loop
Brandon, FL 33511-7121
Phone
(786) 316-2721
NPI assigned
Jul 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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 11007994 FL Primary

Addresses

Primary practice location

623 Barkfield Loop
Brandon, FL 33511-7121

Mailing address

623 Barkfield Loop
Brandon, FL 33511-7121
Phone (786) 316-2721

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
I20220914003419 FL Practitioner - Nurse Practitioner 9931513884

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11007994FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allure Home Health Corp PastSince Oct 2, 2020 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Allure Home Health CorpTampa, FL, CCN 687011 Home health agency Corporate Officer
Corporate Director
W-2 Managing Employee
Operational/Managerial Control
Oct 2, 2020
Oct 2, 2020
Oct 2, 2020
Oct 2, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1649888769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 BARKFIELD LOOP",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335117121",
            "telephone_number": "786-316-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 BARKFIELD LOOP",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335117121",
            "telephone_number": "786-316-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IPARRAGUIRRE GONGORA",
        "first_name": "ORIBERTO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.