Amanda Surujbali, APRN in Tampa, FL - Medicare Nurse Practitioner

Amanda Surujbali, APRN is a medicare enrolled "Nurse Practitioner - Gerontology" in Tampa, Florida. Her current practice location is 2727 W Dr Martin Luther King Jr Blvd Ste 460, Tampa, Florida. You can reach out to her office (for appointments etc.) via phone at (813) 879-4328.

Amanda Surujbali is licensed to practice in Florida (license number APRN11034927) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1407689664.

Contact Information

	Amanda Surujbali, APRN
	2727 W Dr Martin Luther King Jr Blvd Ste 460, Tampa, FL 33607-6001
	(813) 879-4328
	(813) 443-8152

Map and Direction

Provider's Profile

Full Name	Amanda Surujbali
Gender	Female
Speciality	Nurse Practitioner - Gerontology
Location	2727 W Dr Martin Luther King Jr Blvd Ste 460, Tampa, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1407689664
Provider Enumeration Date: 08/22/2024
Last Update Date: 11/21/2024

Medicare PECOS Information:

PECOS PAC ID: 9335671395
Enrollment ID: I20241015002520

Medical Identifiers

Medical identifiers for Amanda Surujbali such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1407689664	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2100X	Nurse Practitioner - Acute Care	11034927 (Florida)	Secondary
363LG0600X	Nurse Practitioner - Gerontology	APRN11034927 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amanda Surujbali allows following entities to bill medicare on her behalf.

Entity Name	Baycare Medical Group, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043269871 PECOS PAC ID: 6406753623 Enrollment ID: O20031216000718

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Surujbali is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Amanda Surujbali, APRN 2995 Drew St, Clearwater, FL 33759-3012 Ph: (727) 315-7496	Amanda Surujbali, APRN 2727 W Dr Martin Luther King Jr Blvd Ste 460, Tampa, FL 33607-6001 Ph: (813) 879-4328

Reviews and Comments

Nurse Practitioner Nurses in Tampa, FL

Charmaine Henry, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15511 N Florida Ave Ste 401, Tampa, FL 33613 Phone: 813-963-3124 Fax: 813-908-7808
Ms. Bridget Shoulders-odom, MS, ACNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13000 Bruce B Downs Bld, Tampa, FL 33612 Phone: 813-972-2000
Ms. Rhea Arlene Hurwitz, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3001 W Martin Luther King Boulevard, Tampa, FL 33607 Phone: 813-554-8511
Dr. Leigh Nicole Montejo, DNP, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 9527 Delaney Creek Blvd, Tampa, FL 33619 Phone: 813-615-5230
Mrs. Dawn Elizabeth White, NP-C Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 2901 W Saint Isabel St, Suite A3, Tampa, FL 33607 Phone: 813-872-4401
Crystal Elaine Blair, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13000 Bruce B Downs Blvd, Tampa, FL 33612 Phone: 813-972-2000
Courtney Pariso, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3010 E 138th Ave, Suite 12, Tampa, FL 33613 Phone: 813-975-2800 Fax: 813-977-7631

Amanda Surujbali, APRN - Medicare Nurse Practitioner in Tampa, FL