Individual provider Active NPI

Suzanne Mariette Pasco

  • Family Nurse Practitioner
  • Leesburg, FL
National Provider Identifier
1942963335
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11016300 Issued in FL
Practice address
4700 That St
Leesburg, FL 34748-9723
Phone
(352) 326-5281
NPI assigned
Oct 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F10210973 FL
Family Nurse Practitioner 363LF0000X APRN11016300 FL Primary

Addresses

Primary practice location

4700 That St
Leesburg, FL 34748-9723

Mailing address

3001 Lake Woodward Dr
Eustis, FL 32726-7373
Phone (352) 205-2871

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
I20220125000424 FL Practitioner - Nurse Practitioner 4789076738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathways Clinical Partners, LLCGroup PAC ID 5597162693, 8 clinicians

Practice addresses (Care Compare)

1031 W Magnolia St
Leesburg, FL 34748-5730
Phone (800) 632-6228

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11016300FLMDFamily Nurse Practitioner
F10210973FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Medical Group LLC CurrentSince Sep 12, 2022 Accepting new patients
To Your Health of Lake County Inc CurrentSince Nov 1, 2021 Accepting new patients
Pathways Clinical Partners, LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

1031 W Magnolia St
Leesburg, FL 34748
Phone (352) 315-0459

4700 That St
Leesburg, FL 34748
Phone (352) 326-5281

Interoperability endpoints

  • Direct secure messaging: spasco594272@direct.shands.ufl.edu
  • FHIR API: https://fhir4.healow.com/fhir/r4/JBDHAD
  • FHIR API: https://api.platform.athenahealth.com/17462/brand/2/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1942963335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 LAKE WOODWARD DR",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327267373",
            "telephone_number": "352-205-2871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 THAT ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347489723",
            "telephone_number": "352-326-5281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCO",
        "first_name": "SUZANNE",
        "middle_name": "MARIETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-11-22",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F10210973",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11016300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.