Individual provider Active NPI

Cory F Asadi-Frazier, NP

  • Pediatric Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1821286170
Registry record updated Dec 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN11000729 Issued in FL
Practice address
601 E Rollins St
Orlando, FL 32803-1248
Phone
(407) 975-0412
Fax
(407) 975-0413
NPI assigned
Oct 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704300463 MI
Pediatric Nurse Practitioner 363LP0200X RN-296830/NP-07044 OH
Pediatric Nurse Practitioner 363LP0200X APRN11000729 FL Primary

Addresses

Primary practice location

601 E Rollins St
Orlando, FL 32803-1248

Mailing address

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 975-0412

Other identifiers 1

IdentifierTypeStateIssuer
2340416MedicaidOH

Other names 1

  • Cory Frazier Antonelli Former 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
I20191212000580 FL Practitioner - Nurse Practitioner 5193956464 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11000729FLMDPediatric Nurse Practitioner
RN-296830/NP-07044OHMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Nurse Practitioner CurrentSince Jan 6, 2020 Accepting new patients
Tenet Florida Physician Services II, LLC CurrentSince Sep 13, 2024 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jan 6, 2020 Accepting new patients
Tenet Florida Physician Services LLC CurrentSince Sep 13, 2024 Accepting new patients
Tenet Florida Physician Services II, LLC Nurse Practitioner Current Accepting new patients

Locations

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

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

927 45th St
Ste 303
Mangonia Park, FL 33407
Phone (561) 833-6116

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

901 Village Blvd
Ste 702
West Palm Beach, FL 33409
Phone (561) 437-0589

5325 Greenwood Ave
Ste 203
West Palm Beach, FL 33407
Phone (561) 736-7313

Interoperability endpoints

  • Direct secure messaging: casadifrazier127910@adventhealth.direct-ci.com
  • Direct secure messaging: cory.asadi-frazier.1@13023.direct.athenahealth.com

Organizations & group practices 5

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": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576368000000",
    "number": "1821286170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-975-0412",
            "fax_number": "407-975-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-975-0412",
            "fax_number": "407-975-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASADI-FRAZIER",
        "first_name": "CORY",
        "middle_name": "F",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2019-12-15",
        "certification_date": "2019-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704300463",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "RN-296830/NP-07044",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11000729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2340416",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORY",
            "last_name": "FRAZIER ANTONELLI",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.