Individual provider Active NPI

Francisca Perdomo, ARNP

  • Acute Care Nurse Practitioner
  • Summerfield, FL
National Provider Identifier
1770026924
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
ARNP9214234 Issued in FL
Practice address
17820 SE 109TH Ave Ste 108
Summerfield, FL 34491
Phone
(352) 693-2340
Fax
(352) 693-2345
NPI assigned
Nov 21, 2016
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 ARNP9214234 FL Primary
Primary Care Nurse Practitioner 363LP2300X ARNP9214234 FL

Addresses

Primary practice location

17820 SE 109TH Ave Ste 108
Summerfield, FL 34491

Mailing address

17820 SE 109TH Ave Ste 108
Summerfield, FL 34491
Phone (352) 693-2340

Other practice location 1

5535 Memorial Hwy
Tampa, FL 33634-7332
Phone (813) 574-4869

Other names 1

  • Francisca Perdomo Professional 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
I20181012001905 FL Practitioner - Nurse Practitioner 7416209812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santos Primary Care Medical Clinics, PLLCGroup PAC ID 9234478926, 7 clinicians

Practice addresses (Care Compare)

17820 SE 109TH Ave
Suite 108
Summerfield, FL 34491-8968
Phone (352) 448-6469

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9214234FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Santos Primary Care Medical Clinics, PLLC CurrentSince Dec 18, 2019 Accepting new patients

Locations

17820 SE 109th Ave
Ste 108
Summerfield, FL 34491
Phone (352) 448-6469

8491 SE 165th Mulberry Ln
The Villages, FL 32162
Phone (352) 304-6480

Interoperability endpoints

  • Direct secure messaging: francisca.gonzalez.1@18060.direct.athenahealth.com

Organizations & group practices 1

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 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": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770026924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17820 SE 109TH AVE STE 108",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "34491",
            "telephone_number": "352-693-2340",
            "fax_number": "352-693-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17820 SE 109TH AVE STE 108",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "34491",
            "telephone_number": "352-693-2340",
            "fax_number": "352-693-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5535 Memorial Hwy",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336347332",
            "country_code": "US",
            "telephone_number": "813-574-4869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERDOMO",
        "first_name": "FRANCISCA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2022-07-21",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "ARNP9214234",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9214234",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FRANCISCA",
            "last_name": "PERDOMO",
            "credential": "ARNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Summerfield, FL

Sources for this page

Verify at the official NPI Registry.