Individual provider Active NPI

Divya Madhuri Persaud, APRN

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1700477684
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11010661 Issued in FL
Practice address
102 Park Place Blvd
Kissimmee, FL 34741-2358
Phone
(407) 944-4900
NPI assigned
Feb 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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 11010661 FL Primary

Addresses

Primary practice location

102 Park Place Blvd
Kissimmee, FL 34741-2358

Mailing address

102 Park Place Blvd
Kissimmee, FL 34741-2358
Phone (407) 944-4900

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
I20210524001716 FL Practitioner - Nurse Practitioner 2365841327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastro Health, LLCGroup PAC ID 2365440567, 246 clinicians

Practice addresses (Care Compare)

10743 Narcoossee Rd
Suite 18B
Orlando, FL 32832-6944
Phone (407) 851-5600

3661 S Miami Ave
Miami, FL 33133-4214
Phone (305) 856-7333

3885 Oakwater Cir
Orlando, FL 32806-6257
Phone (407) 851-5600

7243 Della Dr
Orlando, FL 32819-5104
Phone (305) 468-4185

Merit-based Incentive Payment System (MIPS)

Final score
82.04 of 100Reported as group
Quality
65.4
Promoting interoperability
98
Improvement activities
40
Cost
76.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11010661FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro Health, LLC CurrentSince Jul 5, 2022 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Gastro Health LLC Current Accepting new patients
Gastro Health, LLC CurrentSince Jul 5, 2022 Accepting new patients
The Florida Foot and Ankle Institute CurrentSince Sep 5, 2023 Accepting new patients
Galloway Anesthesia Associates LLC Past Accepting new patients

Locations

4675 Linton Blvd
Ste 202
Delray Beach, FL 33445
Phone (561) 495-5700

102 Park Place Blvd
Kissimmee, FL 34741
Phone (407) 385-0728

3661 S Miami Ave
Ste 907
Miami, FL 33133
Phone (305) 856-7333

10743 Narcoossee Rd
Ste 18B
Orlando, FL 32832

7243 Della Dr
Orlando, FL 32819
Phone (407) 381-7366

3885 Oakwater Cir
Ste 144
Orlando, FL 32806

9964 University Blvd
Orlando, FL 32817
Phone (407) 261-2900

Interoperability endpoints

  • Direct secure messaging: dpersaud231633@orlandohealth.medalliesdirect.net
  • Direct secure messaging: divya.persaud@gastrohealth.eclinicaldirectplus.com

Organizations & group practices 6

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": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1700477684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PARK PLACE BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412358",
            "telephone_number": "407-944-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PARK PLACE BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412358",
            "telephone_number": "407-944-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSAUD",
        "first_name": "DIVYA",
        "middle_name": "MADHURI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11010661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.