Individual provider Active NPI

Toni Cassidy, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1710733662
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11032415 Issued in FL
Practice address
2327 River Park Cir
Orlando, FL 32817-4882
Phone
(907) 821-8122
NPI assigned
Apr 30, 2024
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11032415 FL Primary

Addresses

Primary practice location

2327 River Park Cir
Orlando, FL 32817-4882

Mailing address

787 Summit Ter
Ketchikan, AK 99901-6359
Phone (907) 821-8122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA, NY, TX4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20240613000300 FL Practitioner - Nurse Practitioner 7618419078 Reassigns benefits to 1 organization
I20260320003197 CA Practitioner - Psychiatry 7618419078 Reassigns benefits to 2 organizations
I20260601001936 NY Practitioner - Nurse Practitioner 7618419078 Reassigns benefits to 1 organization
I20260604004607 TX Practitioner - Nurse Practitioner 7618419078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11835 Queens Blvd
Suite 400
Forest Hills, NY 11375-7204

12301 Wilshire Blvd
Suite 512
Los Angeles, CA 90025-1053

5521 Custer Dr
Maryville, TN 37804-4666

708 Main St
FL 4
Houston, TX 77002-0001

708 Main St
FL 4
Houston, TX 77002-3208

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11032415FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Suboxone Health Clinic LLC CurrentSince Jun 5, 2024 Accepting new patients

Locations

2281 Lee Rd
Ste 102
Winter Park, FL 32789
Phone (386) 848-8751

Interoperability endpoints

  • Direct secure messaging: toni.cassidy.1@9357.direct.athenahealth.com

Organizations & group practices 5

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": "1714435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1710733662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 SUMMIT TER",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999016359",
            "telephone_number": "907-821-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2327 RIVER PARK CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328174882",
            "telephone_number": "907-821-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "TONI",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "U",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11032415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.