ASHLEY JENNIFER CUSTODIO (APRN) – Acute Care Nurse Practitioner, NPI 1821643339
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for ASHLEY JENNIFER CUSTODIO (APRN)
8398 NUZUM RD
WEEKI WACHEE, FL 346134543
Phone:
Type: Mailing
4129 N ARMENIA AVE
TAMPA, FL 336076436
Phone: (813) 879-3699
Fax: (813) 873-8469
Type: Mailing
1305, South Ft Harrison Avenue, Clearwater, Pinellas County, Florida, 33756, United States
CLEARWATER, FL 337563301
Phone: (727) 223-3650
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $176.
Total Amount is formed as General ($176) + Research ($0) + Ownership ($0) = $176.
Last reported payment date: 2024-04-24 • Largest payer in this snapshot: Amgen Inc. ($47).
Total Amount
$176
General + Research + Ownership
Payments
8
Total payment records
General Amount
$176
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-24
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2019-10-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20191030000582 | I | Nurse Practitioner | FL | 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 34613)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Practice | FL | |
| Internal Medicine | FL | |
| Internal Medicine | FL | |
| Family Practice | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| General Practice | FL | |
| General Practice | PR | |
| - | FL |
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