SHANE BRIDGMAN (DNP, APRN, AGNP-BC) – Adult Health Nurse Practitioner, NPI 1447762380
Adult Health Nurse Practitioner
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for SHANE BRIDGMAN (DNP, APRN, AGNP-BC)
Medical Plaza Drive, Leesburg, Lake County, Florida, 32748, United States
LEESBURG, FL 347487324
Phone: (352) 728-0709
Type: Mailing
PO BOX 211699
EAGAN, MN 551213699
Phone: (866) 849-0692
Fax: (888) 973-8821
Type: Mailing
36624 GRAND ISLAND OAKS CIR
GRAND ISLAND, FL 327359653
Phone: (352) 801-9272
Fax: (908) 274-2081
Type: Mailing
880 SW 145TH AVE STE 202
PEMBROKE PINES, FL 330276171
Phone: (866) 849-0692
Fax: (888) 973-8821
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $13.
Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.
Last reported payment date: 2024-10-07 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($13).
Total Amount
$13
General + Research + Ownership
Payments
1
Total payment records
General Amount
$13
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $13 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-04-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180302001753 | I | Nurse Practitioner | FL | TBD |
| I20240425000712 | I | Nurse Practitioner | IL | TBD |
| I20240426003042 | I | Nurse Practitioner | AZ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 34748)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| - | FL | |
| - | FL | |
| Pulmonary Disease, Critical Care (Intensivists), Internal Medicine | FL | |
| Pulmonary Disease | FL | |
| Pulmonary Disease, Internal Medicine | FL |
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