Individual provider Active NPI

Marilyn R Barrera, APRN

  • Family Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1972161537
Registry record updated Jun 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11002702 Issued in FL
Practice address
1130 Kyle Wood LN
Brandon, FL 33511-4850
Phone
(813) 600-5423
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2019

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 11002702 FL Primary

Addresses

Primary practice location

1130 Kyle Wood LN
Brandon, FL 33511-4850

Mailing address

12717 Flatwood Creek Dr
Gibsonton, FL 33534-5717
Phone (931) 980-1636

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherNA

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
I20191021001552 FL Practitioner - Nurse Practitioner 5294067484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

3140 S Falkenburg Rd
Suite 201
Riverview, FL 33578-2594
Phone (813) 910-0030

Hospital & facility affiliations

  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
70.52
Promoting interoperability
100
Improvement activities
40
Cost
73.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11002702FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney Physicians, LLC CurrentSince Sep 1, 2019 Accepting new patients
Florida Kidney Physicians , LLC CurrentSince Sep 1, 2019 Accepting new patients
Bay Area Advance Gastroenterology Care Inc PastSince Feb 6, 2012 Accepting new patients

Locations

1150 N 35th Ave
Ste 620
Hollywood, FL 33021
Phone (954) 612-8173

19056 NE 29th Ave
Miami, FL 33180
Phone (305) 354-4558

2001 W Reynolds St
Plant City, FL 33563
Phone (813) 655-1100

3140 S Falkenburg Rd
Ste 201
Riverview, FL 33578

946 Cypress Village Blvd
Ste A
Ruskin, FL 33573

3909 Galen Ct
Ste 102
Sun City Ctr, FL 33573
Phone (813) 634-5502

3419 N Lakeview Dr
Tampa, FL 33618
Phone (813) 844-7600

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: marilyn.barrera.1@15644.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/JDDDCA

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561161600000",
    "number": "1972161537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12717 FLATWOOD CREEK DR",
            "city": "GIBSONTON",
            "state": "FL",
            "postal_code": "335345717",
            "telephone_number": "931-980-1636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 KYLE WOOD LN",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114850",
            "telephone_number": "813-600-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRERA",
        "first_name": "MARILYN",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11002702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.