Individual provider Active NPI

Maureen Ann Rabazinski, APRN

  • Gerontology Nurse Practitioner
  • Viera, FL
National Provider Identifier
1780058990
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN1632562 Issued in FL
Practice address
7000 Spyglass CT.
Ste. 130
Viera, FL 32940-4103
Phone
(321) 247-7063
Fax
(321) 222-5256
NPI assigned
Nov 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN1632562 FL Primary

Addresses

Primary practice location

7000 Spyglass CT.
Ste. 130
Viera, FL 32940-4103

Mailing address

7000 Spyglass CT Ste 501
Viera, FL 32940-8288
Phone (321) 247-7063

Other identifiers 3

IdentifierTypeStateIssuer
7041977OtherCIGNA
016805700MedicaidFL
FWFXQOtherFLFLORIDA BLUE

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
I20160331001428 FL Practitioner - Nurse Practitioner 4183921455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Memory Care LLCGroup PAC ID 5193107936, 2 clinicians

Practice addresses (Care Compare)

Viera, FL 32940
Phone (321) 247-7063

Hospital & facility affiliations

  • Pinnacle Home Care Home health agency, Orlando, FL, CCN 103127
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN1632562FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
My Memory Care LLC CurrentSince Jul 1, 2022 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 29, 2016 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 29, 2016 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

7000 Spyglass Ct
Ste 501
Viera, FL 32940
Phone (321) 247-7063

7000 Spyglass Ct
Ste 130
Viera, FL 32940
Phone (321) 247-7063

1933 Dundee Dr
Winter Park, FL 32792
Phone (407) 622-2647

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1448409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1780058990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 SPYGLASS CT STE 501",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329408288",
            "telephone_number": "321-247-7063",
            "fax_number": "321-222-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 SPYGLASS CT.",
            "address_2": "STE. 130",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329404103",
            "telephone_number": "321-247-7063",
            "fax_number": "321-222-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABAZINSKI",
        "first_name": "MAUREEN",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-25",
        "last_updated": "2023-04-14",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN1632562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7041977",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016805700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "FWFXQ",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Viera, FL

Sources for this page

Verify at the official NPI Registry.