Individual provider Active NPI

Rose Marie Telisnor

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1770097479
Registry record updated Nov 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10171019 Issued in FL
Practice address
2908 Blakely Dr
Orlando, FL 32835-6141
Phone
(786) 859-9984
NPI assigned
Nov 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2017

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 F10171019 FL Primary

Addresses

Primary practice location

2908 Blakely Dr
Orlando, FL 32835-6141

Mailing address

2908 Blakely Dr
Orlando, FL 32835-6141
Phone (786) 859-9984

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
I20180723003135 FL Practitioner - Nurse Practitioner 0749537678 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F10171019FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Management of Florida Inc CurrentSince Nov 1, 2018 Accepting new patients

Locations

2155 SE Federal Hwy
Stuart, FL 34994
Phone (772) 223-9630

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Interoperability endpoints

  • Direct secure messaging: rosemarie.telisnor@wellmed.eclinicaldirectplus.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510876800000",
    "number": "1770097479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 BLAKELY DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356141",
            "telephone_number": "786-859-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 BLAKELY DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356141",
            "telephone_number": "786-859-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELISNOR",
        "first_name": "ROSE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-17",
        "last_updated": "2017-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F10171019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.