Deshae Martin, NURSE PRACTITIONER

Primary specialty

Community Health Nurse PractitionerTaxonomy code 363LC1500X

License

9303768 Issued in FL

Practice address

110 Lithia Pinecrest Rd Ste B
Brandon, FL 33511-5300

Phone

(813) 679-5122

NPI assigned

Jul 27, 2016

Last updated

Aug 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Bay Area Direct Client Care LLC

  • In Home Supportive Care Agency
  • Brandon, FL
  • NPI 1003584301

  5% Or Greater Direct Ownership Interest, Corporate Director, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership
• Bay Area Direct Client Care LLC

  • Clinical & Laboratory Immunology (Internal Medicine) Physician
  • Brandon, FL
  • NPI 1356835862

  5% Or Greater Direct Ownership Interest, Corporate Director, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alliance Coastal Healthcare LLC

  • Acute Care Nurse Practitioner
  • Brandon, FL
  • NPI 1588459226

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Associates in Respiratory Medicine PA

  • Pulmonary Disease Physician
  • Bradenton, FL
  • NPI 1114936903

  Multi-Specialty

  Medicare reassignment NPD
• Bay Area Capital Management LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Ruskin, FL
  • NPI 1790588390
  NPD Authorized official
• Bay Area Direct Client Care LLC

  • In Home Supportive Care Agency
  • Brandon, FL
  • NPI 1003584301
  NPD Authorized official
• Bay Area Direct Client Care LLC

  • Clinical & Laboratory Immunology (Internal Medicine) Physician
  • Brandon, FL
  • NPI 1356835862

  Multi-Specialty

  NPD Authorized official
• Bay Area Healthcare Alliance LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Ruskin, FL
  • NPI 1700667383
  NPD Authorized official
• Alliance Coastal Transit LLC

  • Non-emergency Medical Transport (VAN)
  • Brandon, FL
  • NPI 1770323040
  NPD (past) Authorized official
• Bay Area Direct Client Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Brandon, FL
  • NPI 1457196495
  NPD (past) Authorized official
• Bay Area Direct Client Care LLC

  • Home Health Agency
  • Brandon, FL
  • NPI 1497530885
  NPD (past) Authorized official
• Bay Area Direct Client Care LLC

  • Home Health Agency
  • Orlando, FL
  • NPI 1538935531
  NPD (past) Authorized official
• Bay Area Durable Medical Equipment LLC

  • Durable Medical Equipment & Medical Supplies
  • Brandon, FL
  • NPI 1134905706
  NPD (past) Authorized official
• All Medicine, Inc

  dba Eldridge McCormack, MD PA

  • General Practice Physician
  • Bradenton, FL
  • NPI 1447972088

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1861945719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 ROANOKE SPRINGS DR",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335706312",
            "telephone_number": "813-585-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LITHIA PINECREST RD STE B",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115300",
            "telephone_number": "813-679-5122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2105 Roanoke Springs Dr",
            "address_purpose": "LOCATION",
            "city": "Ruskin",
            "state": "FL",
            "postal_code": "335706312",
            "country_code": "US",
            "telephone_number": "813-585-7708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DESHAE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "9303768",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "FL",
            "license": "9303768",
            "primary": true
        },
        {
            "code": "207RI0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical & Laboratory Immunology",
            "state": "FL",
            "license": "9303768",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019436600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.practicefusion.com/",
            "affiliation": "N",
            "endpointDescription": "Emar",
            "address_1": "110 Lithia Pinecrest Rd Ste B",
            "city": "Brandon",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335115300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Lynn Marrese, MSW
• Ari Marsh, MD
• Aaron Marshall, PTA
• Cynthia Marshall, OT
• Tamara Martin Torres, APRN, FNP
• Doris Martin, NURSE ANESTHETIS
• Lisa A Martin, ARNP
• Reta Passwaters Martin, LCSW
• Samantha Marie Martin, PT, DPT, BS
• Sophia Martin, PA-C

• Community Health Nurse Practitioner in Brandon, FL
• Providers in Brandon, FL by specialty
• Community Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.