Individual provider Active NPI

Julian Leonie Bassaragh, APRN

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1700348497
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11011034 Issued in FL
Practice address
2546 Simpson Road
Kissimmee, FL 34744
Phone
(407) 632-4217
Fax
(407) 632-4226
NPI assigned
Apr 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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 APRN11011034 FL Primary

Addresses

Primary practice location

2546 Simpson Road
Kissimmee, FL 34744

Mailing address

PO Box 4189
Deerfield Beach, FL 33442-4189
Phone (954) 363-9582

Other practice location 1

819 N Central Ave Ste B
Kissimmee, FL 34741-5027
Phone (407) 874-1440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20190612002451 UT Practitioner - Nurse Practitioner 5890028518

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Xpress Urgent Care, LLC. CurrentSince Jun 25, 2023 Accepting new patients
Xpress Urgent Care, LLC. PastSince Apr 3, 2022 Accepting new patients

Locations

2546 Simpson Rd
Kissimmee, FL 34744
Phone (407) 632-4217

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1700348497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4189",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334424189",
            "telephone_number": "954-363-9582",
            "fax_number": "954-363-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2546 SIMPSON ROAD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34744",
            "telephone_number": "407-632-4217",
            "fax_number": "407-632-4226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "819 N Central Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347415027",
            "country_code": "US",
            "telephone_number": "407-874-1440",
            "fax_number": "407-874-1441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASSARAGH",
        "first_name": "JULIAN",
        "middle_name": "LEONIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11011034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.