Priscila Simon Jose, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11035219 Issued in FL

Practice address

340 NW Commerce Dr
Lake City, FL 32055-4709

Phone

(386) 719-9000

NPI assigned

Sep 11, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baya Urgent Care LLCGroup PAC ID 7911124102, 9 clinicians

Emergency Medicine Services of FL LLCGroup PAC ID 8426413931, 686 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Baya Urgent Care LLC

  • Urgent Care Clinic/Center
  • Lake City, FL
  • NPI 1447688619
  Medicare reassignment Care Compare group NPD
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1861228272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7480 S STATE ROAD 121",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320635450",
            "telephone_number": "386-249-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 NW COMMERCE DR",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554709",
            "telephone_number": "386-719-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON JOSE",
        "first_name": "PRISCILA",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11035219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Sikes, MPH, RDN
• Myrna Silva
• Silver Leaf Therapy LLC
• Dean Silverberg, DO
• Princess Justice Simmons
• Jennifer Nguyen Simpson, M.D.
• Vir Vikram Singh, M.D.
• Chasidy Dionne Singleton, M.D.
• Supachoke - Sirisuwanangkura, MD
• Benjamin M Sloan

• Family Nurse Practitioner in Lake City, FL
• Providers in Lake City, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.