Individual provider Active NPI

Ibis E Gonzalez, APRN

  • Adult Health Nurse Practitioner
  • Longwood, FL
National Provider Identifier
1689393019
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11021537 Issued in FL
Practice address
555 W Sr 434
Longwood, FL 32750-5119
Phone
(407) 767-1200
NPI assigned
Aug 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11021537 FL
Adult Health Nurse Practitioner 363LA2200X APRN11021537 FL Primary

Addresses

Primary practice location

555 W Sr 434
Longwood, FL 32750-5119

Mailing address

555 W Sr 434
Longwood, FL 32750-5119
Phone (321) 842-2994

Other names 1

  • Ibis E Echemendia Former name

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
I20221012003510 FL Practitioner - Nurse Practitioner 4981070182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

555 W State Rd
343 MP SS Admin
Longwood, FL 32750-5119
Phone (321) 842-2994

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2022 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2022 Accepting new patients
Orlando Health, Inc. Current Accepting new patients

Locations

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

555 W State Road 434
#343
Longwood, FL 32750
Phone (321) 842-2994

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: iechemendia23745@orlandohealth.medalliesdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1689393019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W SR 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505119",
            "telephone_number": "321-842-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W SR 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505119",
            "telephone_number": "407-767-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "IBIS",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11021537",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11021537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IBIS",
            "last_name": "ECHEMENDIA",
            "middle_name": "E",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.