Individual provider Active NPI

Aji Valayil Achuthan, ARNP

  • Family Nurse Practitioner
  • Tavares, FL
National Provider Identifier
1023489309
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9241888 Issued in FL
Practice address
1741 David Walker Dr
Tavares, FL 32778-5745
Phone
(352) 742-3578
Fax
(352) 742-3581
NPI assigned
Oct 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 ARNP9241888 FL Primary

Addresses

Primary practice location

1741 David Walker Dr
Tavares, FL 32778-5745

Mailing address

3090 Caruso CT Ste 50
Orlando, FL 32806-8510
Phone (407) 481-7179

Other practice location 1

555 W State Road 434
Longwood, FL 32750-5119
Phone (321) 842-2994

Other identifiers 1

IdentifierTypeStateIssuer
016521900MedicaidFL

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
I20160122001153 FL Practitioner - Nurse Practitioner 0244533396 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1000 Waterman Way
Tavares, FL 32778-5266
Phone (352) 742-3581

10000 W Colonial Dr
Ocoee, FL 34761-3400
Phone (407) 578-0033

17000 Porter Rd
Winter Garden, FL 34787-8915

1900 Don Wickham Dr
Clermont, FL 34711-1979

32 W Gore St
Orlando, FL 32806-1134

380 Rinehart Rd
Lake Mary, FL 32746-2551
Phone (407) 767-1200

60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980
Phone (386) 586-2000

Hospital & facility affiliations

  • Adventhealth Waterman Hospital, Tavares, FL, CCN 100057
  • Orlando Health-Health Central Hospital Hospital, Ocoee, FL, CCN 100030
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
  • Orlando Health Hospital, Orlando, FL, CCN 100006

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Florida Hospital Healthcare Partners, Inc CurrentSince Oct 1, 2018 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2018 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2018 Accepting new patients

Locations

601 E Altamonte Dr
Altamonte Springs, FL 32701
Phone (407) 303-2200

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: aachuthan70903@adventhealth.direct-ci.com
  • Direct secure messaging: aachuthan27835@orlandohealth.medalliesdirect.net

Organizations & group practices 4

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 5

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": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1023489309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 CARUSO CT STE 50",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328068510",
            "telephone_number": "407-481-7179",
            "fax_number": "407-481-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 DAVID WALKER DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785745",
            "telephone_number": "352-742-3578",
            "fax_number": "352-742-3581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 W State Road 434",
            "address_purpose": "LOCATION",
            "city": "Longwood",
            "state": "FL",
            "postal_code": "327505119",
            "country_code": "US",
            "telephone_number": "321-842-2994",
            "fax_number": "407-767-5801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACHUTHAN",
        "first_name": "AJI",
        "middle_name": "VALAYIL",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9241888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016521900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.