Individual provider Active NPI

Alicia Gomrad, ARNP

  • Pediatric Nurse Practitioner
  • Maitland, FL
National Provider Identifier
1821461476
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
9266605 Issued in FL
Practice address
210 Lookout PL
Maitland, FL 32751-4491
Phone
(407) 215-0400
NPI assigned
Nov 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 9266605 FL Primary

Addresses

Primary practice location

210 Lookout PL
Maitland, FL 32751-4491

Mailing address

827 Seneca Meadows Rd
Winter Springs, FL 32708-4730
Phone (321) 279-0896

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
I20250212003870 FL Order and Referring Only - Nurse Practitioner 4880124346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9266605FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Pediatrics of Central Florida Past Accepting new patients
Sunshine Pediatrics of Central Florida, PL Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13830/brand/1/csg/1/fhir/r4

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": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1821461476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 SENECA MEADOWS RD",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327084730",
            "telephone_number": "321-279-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LOOKOUT PL",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514491",
            "telephone_number": "407-215-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMRAD",
        "first_name": "ALICIA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "9266605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.