Individual provider Active NPI

Mirelys Maldonado, APRN

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1851926703
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11006139 Issued in FL
Practice address
700 W Oak St
Kissimmee, FL 34741-4924
Phone
(407) 518-3280
NPI assigned
Mar 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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 11006139 FL Primary

Addresses

Primary practice location

700 W Oak St
Kissimmee, FL 34741-4924

Mailing address

418 Tamarind Parke LN
Kissimmee, FL 34758-3635
Phone (407) 694-0945

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
I20210426001559 FL Practitioner - Nurse Practitioner 4688082910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Florida Physician Network LLCGroup PAC ID 5193895969, 10 clinicians

Practice addresses (Care Compare)

591 Oak Commons Blvd
Kissimmee, FL 34741-4202
Phone (407) 943-7100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.65 of 100Reported as group
Quality
99.01
Promoting interoperability
99
Improvement activities
40
Cost
65.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11006139FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Physician Network LLC CurrentSince Jan 9, 2021 Accepting new patients

Locations

700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553

591 Oak Commons Blvd
Kissimmee, FL 34741
Phone (407) 343-2700

1401 W Seminole Blvd
Fl Regi
Sanford, FL 32771
Phone (407) 302-2620

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mirelys.maldonado@hca4.eclinicaldirectplus.com

Organizations & group practices 1

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 1

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": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1851926703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 TAMARIND PARKE LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347583635",
            "telephone_number": "407-694-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414924",
            "telephone_number": "407-518-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "MIRELYS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11006139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.