Individual provider Active NPI

Cristina H Dstteffano, APRN

  • Family Nurse Practitioner
  • Clermont, FL
National Provider Identifier
1780424465
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9478319 Issued in FL
Practice address
1101 Harmony LN
Clermont, FL 34711-9021
Phone
(973) 413-3910
NPI assigned
May 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 9478319 FL Primary

Addresses

Primary practice location

1101 Harmony LN
Clermont, FL 34711-9021

Mailing address

1101 Harmony LN
Clermont, FL 34711-9021
Phone (973) 413-3910

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
I20240730004257 FL Practitioner - Nurse Practitioner 1052858750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lowell F. Clark MD PAGroup PAC ID 7416918370, 31 clinicians

Practice addresses (Care Compare)

107 W Central Ave
Howey in the Hills, FL 34737-4302
Phone (352) 324-0504

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9478319FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lowell F. Clark MD PA CurrentSince Jul 16, 2024 Accepting new patients
Lowell F. Clark MD PA Single Specialty CurrentSince Jul 16, 2024 Accepting new patients

Locations

212 S Florida St
Bushnell, FL 33513
Phone (352) 793-2441

107 W Central Ave
Howey in the Hills, FL 34737
Phone (352) 324-0504

910 W Myers Blvd
Mascotte, FL 34753
Phone (352) 557-8700

Organizations & group practices 2

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": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1780424465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 HARMONY LN",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347119021",
            "telephone_number": "973-413-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HARMONY LN",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347119021",
            "telephone_number": "973-413-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DSTTEFFANO",
        "first_name": "CRISTINA",
        "middle_name": "H",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9478319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.