Theresa Marie Laurente, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

9264424 Issued in FL

Practice address

4710 N Habana Ave Ste 300
Tampa, FL 33614-7151

Phone

(813) 873-1016

Fax

(813) 874-2813

NPI assigned

Aug 8, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Maria Theresa Gelok Former name

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

National Kidney Partners LLPGroup PAC ID 7012981350, 63 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: tlaurente77178@direct.acumenmd.com

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.

• National Kidney Partners, LLP

  • Nephrology Physician
  • Hudson, FL
  • NPI 1780684795
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1932653920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 N HABANA AVE STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147151",
            "telephone_number": "813-873-1016",
            "fax_number": "813-874-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 N HABANA AVE STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147151",
            "telephone_number": "813-873-1016",
            "fax_number": "813-874-2813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11180 Warner Ave",
            "address_2": "#463",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927087501",
            "country_code": "US",
            "telephone_number": "714-241-9200",
            "fax_number": "714-241-9109",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11180 Warner Ave",
            "address_2": "#463",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927087501",
            "country_code": "US",
            "telephone_number": "714-241-9200",
            "fax_number": "714-241-9109",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4710 N Habana Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336147146",
            "country_code": "US",
            "telephone_number": "813-873-1016",
            "fax_number": "813-874-2813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4710 N Habana Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336147146",
            "country_code": "US",
            "telephone_number": "813-873-1016",
            "fax_number": "813-874-2813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAURENTE",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95004603",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9264424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "GELOK",
            "middle_name": "THERESA",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.