Individual provider Active NPI

Marina B Ross

  • Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
  • Lady Lake, FL
National Provider Identifier
1669936258
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Family Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0810X
License
APRN11001032 Issued in FL
Practice address
305 Skyline Dr Ste 1
Lady Lake, FL 32159-4592
Phone
(352) 431-3940
Fax
(352) 431-3173
NPI assigned
Jan 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist 364SP0810X APRN11001032 FL Primary

Addresses

Primary practice location

305 Skyline Dr Ste 1
Lady Lake, FL 32159-4592

Mailing address

104 E Dixie Ave
Leesburg, FL 34748-6350
Phone (352) 431-3940

Other practice location 1

104 E Dixie Ave
Leesburg, FL 34748-6350
Phone (352) 431-3940

Other identifiers 1

IdentifierTypeStateIssuer
APRN11001032OtherFLLICENSE

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
I20190320000158 FL Practitioner - Nurse Practitioner 1658611124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harmony United Florida, LLCGroup PAC ID 9638306673, 86 clinicians

Practice addresses (Care Compare)

15544 W Colonial Dr
Winter Garden, FL 34787-9556
Phone (352) 431-3940

3235 SW 34TH St
Ocala, FL 34474-7501
Phone (352) 431-3940

Merit-based Incentive Payment System (MIPS)

Final score
81.81 of 100Reported as group
Quality
80.53
Improvement activities
40
Cost
75.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11001032FLMDChild & Family Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony United Florida, LLC CurrentSince Feb 4, 2019 Accepting new patients

Locations

305 Skyline Dr
Ste 1
Lady Lake, FL 32159
Phone (352) 451-1521

104 E Dixie Ave
Leesburg, FL 34748
Phone (352) 451-1521

3235 SW 34th St
Ocala, FL 34474
Phone 3525059115 ext. 100

15544 W Colonial Dr
Winter Garden, FL 34787
Phone (352) 504-0340

Interoperability endpoints

  • Direct secure messaging: marina.ross@harmonyhealthcare.medentdirect.com

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": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1669936258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347486350",
            "telephone_number": "352-431-3940",
            "fax_number": "352-431-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SKYLINE DR STE 1",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321594592",
            "telephone_number": "352-431-3940",
            "fax_number": "352-431-3173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 E Dixie Ave",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347486350",
            "country_code": "US",
            "telephone_number": "352-431-3940",
            "fax_number": "352-431-3173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "MARINA",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-28",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0810X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Family",
            "state": "FL",
            "license": "APRN11001032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "APRN11001032",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

Verify at the official NPI Registry.