Individual provider Active NPI

Denise Digregorio, FNP

  • Family Nurse Practitioner
  • Bradenton, FL
National Provider Identifier
1861907313
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9395060 Issued in FL
Practice address
8340 Lakewood Ranch Blvd
Suite 210
Bradenton, FL 34202-5185
Phone
(941) 782-2800
Fax
(941) 782-2513
NPI assigned
Dec 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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 ARNP9395060 FL Primary

Addresses

Primary practice location

8340 Lakewood Ranch Blvd
Suite 210
Bradenton, FL 34202-5185

Mailing address

367 S. Gulph Rd
Attn: Ipm Credentialing
King of Prussia, PA 19406-3121
Phone (941) 782-2800

Other practice location 1

5235 El Cerro Dr
New Port Richey, FL 34655-5236
Phone (813) 230-1247

Other names 1

  • Denise Russo 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
I20190102002094 FL Practitioner - Nurse Practitioner 8325383854 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9395060FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Polmed PA CurrentSince Jun 17, 2018 Accepting new patients
Manatee Physician Alliance, LLC CurrentSince Jul 15, 2019 Accepting new patients

Locations

206 2nd St E
Bradenton, FL 34208
Phone (941) 745-7202

8340 Lakewood Ranch Blvd
Ste 210
Lakewood Ranch, FL 34202
Phone (941) 556-8930

1803 Briar Creek Blvd
Safety Harbor, FL 34695
Phone (727) 216-0505

367 S Gulph Rd
Kng of Prussa, PA 19406
Phone (610) 382-4422

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": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1861907313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S. GULPH RD",
            "address_2": "ATTN: IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "941-782-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8340 LAKEWOOD RANCH BLVD",
            "address_2": "SUITE 210",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342025185",
            "telephone_number": "941-782-2800",
            "fax_number": "941-782-2513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5235 El Cerro Dr",
            "address_purpose": "LOCATION",
            "city": "New Port Richey",
            "state": "FL",
            "postal_code": "346555236",
            "country_code": "US",
            "telephone_number": "813-230-1247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIGREGORIO",
        "first_name": "DENISE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9395060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "RUSSO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.