Individual provider Active NPI

Ariadna Cabrera Gongora, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1780347203
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11015546 Issued in FL
Practice address
1100 Cesery Blvd
Jacksonville, FL 32211-5674
Phone
(904) 551-5884
NPI assigned
Oct 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 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 APRN11015546 FL Primary

Addresses

Primary practice location

1100 Cesery Blvd
Jacksonville, FL 32211-5674

Mailing address

10953 Beckley PL
Jacksonville, FL 32246-6626
Phone (904) 233-8150

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Jacksonville Health Information Exchange (HIE)

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
I20211111001818 FL Practitioner - Nurse Practitioner 0547659682 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Florida Jacksonville Physicians, Inc. 908 clinicians

Practice addresses (Care Compare)

11481 Old Saint Augustine Rd
Suite 101
Jacksonville, FL 32258-1474
Phone (904) 633-0210

450077 State Rd
Suite 12
Callahan, FL 32011-3863
Phone (904) 633-0560

Hospital & facility affiliations

  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11015546FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Mar 6, 2023 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Mar 6, 2023 Accepting new patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Mar 6, 2023 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Past Accepting new patients

Locations

450077 State Road 200
Ste 12
Callahan, FL 32011
Phone (904) 633-0560

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

11481 Old Saint Augustine Rd
Ste 101
Jacksonville, FL 32258
Phone (904) 633-0210

1255 Lila St
Jacksonville, FL 32208
Phone (904) 244-5700

Interoperability endpoints

  • Direct secure messaging: agongora153573@direct.shands.ufl.edu

Organizations & group practices 7

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 2

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": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1780347203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10953 BECKLEY PL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322466626",
            "telephone_number": "904-233-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CESERY BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115674",
            "telephone_number": "904-551-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRERA GONGORA",
        "first_name": "ARIADNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11015546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1100 Cesery Blvd",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322115674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.