Individual provider Active NPI

Jacob Allen Flatten, AGAC-DNP

  • Adult Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1962395392
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11040471 Issued in FL
Practice address
22 Underwood St
Orlando, FL 32806-1110
Phone
(407) 648-3800
Fax
(407) 872-7754
NPI assigned
Jun 3, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 2465074 MN
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X APRN11040471 FL Primary

Addresses

Primary practice location

22 Underwood St
Orlando, FL 32806-1110

Mailing address

22 Underwood St
Orlando, FL 32806-1110
Phone (407) 648-3800

Other identifiers 1

IdentifierTypeStateIssuer
129019200MedicaidFL

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
I20251112001291 FL Practitioner - Nurse Practitioner 9032600689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

22 W Underwood St
Orlando, FL 32806-1110
Phone (407) 648-3800

32 W Gore St
Orlando, FL 32806-1134

52 W Underwood St
Orlando, FL 32806-1110
Phone (407) 841-5111

76 W Underwood St
Orlando, FL 32806-1110

86 W Underwood St
Orlando, FL 32806-1110
Phone (407) 896-1100

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2465074MNMDGeneral Practice Registered Nurse
APRN11040471FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Multi-Specialty CurrentSince Oct 1, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2025 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

22 Underwood St
Orlando, FL 32806
Phone (321) 841-6263

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

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": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1962395392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 UNDERWOOD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "407-648-3800",
            "fax_number": "407-872-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 UNDERWOOD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "407-648-3800",
            "fax_number": "407-872-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLATTEN",
        "first_name": "JACOB",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "AGAC-DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MN",
            "license": "2465074",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11040471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129019200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.