Shane Bridgman, DNP, APRN, AGNP-BC is a medicare enrolled "Nurse Practitioner - Adult Health" in Grand Island, Florida. His current practice location is
36624 Grand Island Oaks Cir, Grand Island, Florida. You can reach out to his office (for appointments etc.) via phone at
(352) 801-9272.
Shane Bridgman is licensed to practice in Florida (license number APRN9325995) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1447762380.
Provider's Profile
| Full Name | Shane Bridgman |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Adult Health |
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| Location | 36624 Grand Island Oaks Cir, Grand Island, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1447762380
- Provider Enumeration Date: 11/01/2017
- Last Update Date: 12/15/2025
Medicare PECOS Information:
- PECOS PAC ID: 0749541902
- Enrollment ID: I20180302001753
Medical Identifiers
Medical identifiers for Shane Bridgman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1447762380 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363L00000X | Nurse Practitioner | 2024045190 (Missouri) | Secondary |
| 363L00000X | Nurse Practitioner | 291383 (Arizona) | Secondary |
| 363L00000X | Nurse Practitioner | 1112411 (Texas) | Secondary |
| 363L00000X | Nurse Practitioner | 4035372 (Kentucky) | Secondary |
| 363L00000X | Nurse Practitioner | 209028336 (Illinois) | Secondary |
| 363L00000X | Nurse Practitioner | 0033013 (Ohio) | Secondary |
| 363L00000X | Nurse Practitioner | 29997 (South Carolina) | Secondary |
| 363L00000X | Nurse Practitioner | 38021 (Tennessee) | Secondary |
| 363L00000X | Nurse Practitioner | SP032050 (Pennsylvania) | Secondary |
| 363LA2200X | Nurse Practitioner - Adult Health | APRN9325995 (Florida) | Primary |
| 363L00000X | Nurse Practitioner | 3-001918 (Alabama) | Secondary |
| 363L00000X | Nurse Practitioner | C-APN.0102962-C-NP (Colorado) | Secondary |
| 363LG0600X | Nurse Practitioner - Gerontology | APRN9325995 (Florida) | Secondary |
| 363L00000X | Nurse Practitioner | 10040595 (Oregon) | Secondary |
| 363L00000X | Nurse Practitioner | 907225 (Mississippi) | Secondary |
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. Shane Bridgman allows following entities to bill medicare on his behalf.
| Entity Name | Devoted Medical Group Professional Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245838168
PECOS PAC ID: 3072902816
Enrollment ID: O20220815001105 |
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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. Shane Bridgman 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 |
|---|
Shane Bridgman, DNP, APRN, AGNP-BC
36624 Grand Island Oaks Cir,
Grand Island, FL 32735-9653
Ph: (352) 801-9272 | Shane Bridgman, DNP, APRN, AGNP-BC
36624 Grand Island Oaks Cir,
Grand Island, FL 32735-9653
Ph: (352) 801-9272 |
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