Individual provider Active NPI

Paul Bigenho, APRN

  • Family Nurse Practitioner
  • Ormond Beach, FL
National Provider Identifier
1881390284
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11024367 Issued in FL
Practice address
1240 W Granada Blvd FL 2
Ormond Beach, FL 32174-5915
Phone
(386) 672-1023
Fax
(386) 263-2996
NPI assigned
Feb 7, 2023
Last updated
Feb 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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 APRN11024367 FL Primary

Addresses

Primary practice location

1240 W Granada Blvd FL 2
Ormond Beach, FL 32174-5915

Mailing address

2 Marsh Ridge Watch
Ormond Beach, FL 32174-2411
Phone (305) 951-9224

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
I20230317002693 FL Practitioner - Nurse Practitioner 1850765686 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Cardiology Care, P.a. CurrentSince Nov 15, 2022 Accepting new patients

Locations

1240 W Granada Blvd
Ste 2
Ormond Beach, FL 32174
Phone (386) 424-8440

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.

NPI Registry JSON

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1881390284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MARSH RIDGE WATCH",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321742411",
            "telephone_number": "305-951-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 W GRANADA BLVD FL 2",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745915",
            "telephone_number": "386-672-1023",
            "fax_number": "386-263-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIGENHO",
        "first_name": "PAUL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11024367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.