Capricorn Healthcare Services LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH24697 Issued in FL

Legal business name

CAPRICORN HEALTHCARE SERVICES LLC

Doing business as

Hillsboro Specialty Pharmacy, Blood Pressure and Diabetic Ce

Practice address

4505 E Hillsborough Ave Ste D&E
Suite D & E
Tampa, FL 33610-5200

Phone

(813) 628-8400

Fax

(813) 628-8484

NPI assigned

Jun 21, 2010

Last updated

Apr 17, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adenike Niki Gansallo, BSC PHARMACY

Title

President

Phone

(813) 628-8400

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• HILLSBORO SPECIALTY PHARMACY, BLOOD PRESSURE AND DIABETIC CE Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Capricorn Healthcare Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Capricorn Healthcare Services LLC

  dba Access Healthcare Links

  • Home Health Agency
  • Tampa, FL
  • NPI 1497264642
  NPD tax ID

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Capricorn Healthcare Services LLC

  dba Access Healthcare Links

  • Home Health Agency
  • Tampa, FL
  • NPI 1497264642
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adenike Christiana Gansallo, PHARMACIST

  • Pharmacist
  • Lutz, FL
  • NPI 1114080652
  NPD
• Vincent Adeyanju

  • Licensed Practical Nurse
  • Tampa, FL
  • NPI 1124503347
  NPD (past)

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1932420247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 E HILLSBOROUGH AVE STE D&E",
            "address_2": "SUITE D & E",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336105200",
            "telephone_number": "813-628-8400",
            "fax_number": "813-628-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 E HILLSBOROUGH AVE STE D&E",
            "address_2": "SUITE D & E",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336105200",
            "telephone_number": "813-628-8400",
            "fax_number": "813-628-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPRICORN HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-21",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "GANSALLO",
        "authorized_official_first_name": "ADENIKE    NIKI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-628-8400",
        "authorized_official_credential": "BSC PHARMACY"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH24697",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125531",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002675800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HILLSBORO SPECIALTY PHARMACY, BLOOD PRESSURE AND DIABETIC CE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Capri and Associates PA (Carrollwood Internal Medicine)
• Patrick Nicholas Capri Jr., ACUPUNCTURIST
• Patrick Nicholas Capri, M.D.
• Teresa Caprice, PA-C
• Capricorn Healthcare Services LLC (Access Healthcare Links)
• Capstone Eye Care Group of Florida LLC (Pearle Vision - S Tampa)
• Melissa Capurro, PT, DPT, MS
• Lissa Frances Capuson, NP
• Justine Caputi
• Jennifer M Caputo-Seidler

• Community/Retail Pharmacy in Tampa, FL
• Providers in Tampa, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.