Individual provider Active NPI

Roby Abraham

  • Certified Registered Nurse Anesthetist
  • Brooksville, FL
National Provider Identifier
1679224877
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
139310 Issued in FL
Practice address
11375 Cortez Blvd
Brooksville, FL 34613-5409
Phone
(352) 596-6632
NPI assigned
Jan 10, 2022
Last updated
Jan 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 139310 FL Primary

Addresses

Primary practice location

11375 Cortez Blvd
Brooksville, FL 34613-5409

Mailing address

4806 Foxshire Cir
Tampa, FL 33624-4310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220722000128 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082095070 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Florida LLCGroup PAC ID 8921522376, 43 clinicians
St Lukes Cataract and Laser InstituteGroup PAC ID 7517853948, 54 clinicians

Practice addresses (Care Compare)

10461 Quality Dr
Spring Hill, FL 34609-9634
Phone (352) 688-8200

12900 Cortez Blvd
Suite 103
Brooksville, FL 34613-6897
Phone (352) 596-1145

17240 Cortez Blvd
Brooksville, FL 34601-8921
Phone (352) 796-5111

25232 State Rd
54 Suite 1
Lutz, FL 33559-6244
Phone (727) 943-3111

7050 Gall Blvd
Zephyrhills, FL 33541-1347
Phone (813) 788-0411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
139310FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Cataract & Laser Institute Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2025 Accepting new patients
Northstar Anesthesia of Florida LLC CurrentSince Apr 19, 2025 Accepting new patients

Locations

12900 Cortez Blvd
Ste 103
Brooksville, FL 34613
Phone (352) 596-1145

25232 State Road 54
Lutz, FL 33559
Phone (727) 943-3111

25232 State Road 54
Ste 1
Lutz, FL 33559
Phone (727) 943-3111

43309 US Highway 19 N
Tarpon Springs, FL 34689
Phone (727) 938-2020

Interoperability endpoints

  • Direct secure messaging: roby.abraham.p1@direct.stlukeseye.nextgenshare.com

Organizations & group practices 3

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.

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": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1679224877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4806 FOXSHIRE CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336244310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11375 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135409",
            "telephone_number": "352-596-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "ROBY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "139310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.