Individual provider Active NPI

Ranceila Tanahiry Benitez Altagracia, APRN

  • Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1912721101
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11035546 Issued in FL
Practice address
5979 Vineland Rd Ste 206
Orlando, FL 32819-7855
Phone
(407) 352-9300
Fax
(407) 351-6509
NPI assigned
Nov 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11035546 FL Primary

Addresses

Primary practice location

5979 Vineland Rd Ste 206
Orlando, FL 32819-7855

Mailing address

PO Box 878
Davenport, FL 33836-0878
Phone (689) 223-3898

Other practice location 1

829 E Oak St Ste C
Kissimmee, FL 34744-5829
Phone (407) 352-9300

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
I20241203003577 FL Practitioner - Nurse Practitioner 0840726634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Medical Associates, LLCGroup PAC ID 9436285079, 2 clinicians

Practice addresses (Care Compare)

5979 Vineland Rd
Suite 206
Orlando, FL 32819-7855
Phone (407) 352-9300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11035546FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Medical Associates, LLC CurrentSince Dec 2, 2024 Accepting new patients
Elite Medical Associates, LLC CurrentSince Dec 2, 2024 Accepting new patients

Locations

829 E Oak St
Ste C
Kissimmee, FL 34744
Phone (209) 205-8808

5979 Vineland Rd
Ste 206
Orlando, FL 32819
Phone (407) 352-9300

Interoperability endpoints

  • Direct secure messaging: ranceila.benitez.altagracia.1@31641.direct.athenahealth.com

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": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1912721101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 878",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338360878",
            "telephone_number": "689-223-3898",
            "fax_number": "689-223-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 VINELAND RD STE 206",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197855",
            "telephone_number": "407-352-9300",
            "fax_number": "407-351-6509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "829 E Oak St Ste C",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347445829",
            "country_code": "US",
            "telephone_number": "407-352-9300",
            "fax_number": "407-351-6509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENITEZ ALTAGRACIA",
        "first_name": "RANCEILA",
        "middle_name": "TANAHIRY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11035546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.