Individual provider Active NPI

Irena Stefan, APRN

  • Family Nurse Practitioner
  • Palmetto, FL
National Provider Identifier
1871140087
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11003277 Issued in FL
Practice address
2209 10TH Ave E
Palmetto, FL 34221-4104
Phone
(941) 286-8438
NPI assigned
Aug 22, 2019
Last updated
Aug 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 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 11003277 FL Primary

Addresses

Primary practice location

2209 10TH Ave E
Palmetto, FL 34221-4104

Mailing address

2209 10TH Ave E
Palmetto, FL 34221-4104
Phone (941) 286-8438

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
I20200402000088 FL Practitioner - Nurse Practitioner 9739518309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shahul Hameed Riazudeen MD PAGroup PAC ID 3779676481, 2 clinicians

Practice addresses (Care Compare)

16541 S US Hwy 301
Wimauma, FL 33598-2032
Phone (813) 633-1100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11003277FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shahul Hameed Riazudeen MD PA CurrentSince Nov 1, 2021 Accepting new patients

Locations

16541 S US Highway 301
Wimauma, FL 33598
Phone (813) 633-1100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1871140087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 10TH AVE E",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342214104",
            "telephone_number": "941-286-8438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 10TH AVE E",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342214104",
            "telephone_number": "941-286-8438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFAN",
        "first_name": "IRENA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11003277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto, FL

Sources for this page

Verify at the official NPI Registry.