Individual provider Active NPI

Donna Malkovich, ARNP

  • Family Nurse Practitioner
  • Seminole, FL
National Provider Identifier
1922453067
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9243955 Issued in FL
Practice address
11925 Mandarin CT
Seminole, FL 33772
Phone
(727) 688-9968
NPI assigned
Apr 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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 9243955 FL Primary

Addresses

Primary practice location

11925 Mandarin CT
Seminole, FL 33772

Mailing address

11925 Mandarin CT
Seminole, FL 33772
Phone (727) 688-9968

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
I20190703000434 FL Practitioner - Nurse Practitioner 5890053458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11125 Park Blvd
Suite 118
Seminole, FL 33772-4700
Phone (727) 623-4384

Hospital & facility affiliations

  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9243955FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Donna Malkovich Aprn LLC Family CurrentSince Nov 1, 2019 Accepting new patients

Locations

8229 113th St
Seminole, FL 33772
Phone (727) 398-3999

11125 Park Blvd
Ste 118
Seminole, FL 33772
Phone (727) 688-9968

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1922453067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11925 MANDARIN CT",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "33772",
            "telephone_number": "727-688-9968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11925 MANDARIN CT",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "33772",
            "telephone_number": "727-688-9968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALKOVICH",
        "first_name": "DONNA",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9243955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

Verify at the official NPI Registry.