Individual provider Active NPI

Jason Wittlin, FNP-C

  • Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1033718986
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11009951 Issued in FL
Practice address
2000 SW Archer Rd
Gainesville, FL 32610-4495
Phone
(352) 273-8656
NPI assigned
Oct 21, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F09201237 FL
Nurse Practitioner 363L00000X APRN11009951 FL Primary

Addresses

Primary practice location

2000 SW Archer Rd
Gainesville, FL 32610-4495

Mailing address

PO Box 100226
Gainesville, FL 32610-0226

Other practice location 1

630 N Main St
Williston, FL 32696-1705
Phone (352) 528-0587

Other practice location 2

23343 NW County Road 236
High Springs, FL 32643-9669
Phone (352) 463-4520

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
I20210927002215 FL Practitioner - Nurse Practitioner 6406253921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Clinical Practice Association IncGroup PAC ID 0345146254, 1,886 clinicians

Practice addresses (Care Compare)

2000 SW Archer Rd
Uf Health Medical Specialties Medical Plaza
Gainesville, FL 32608-1136
Phone (352) 265-0139

Hospital & facility affiliations

  • Uf Health Shands Hospital Hospital, Gainesville, FL, CCN 100113

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F09201237FLMDFamily Medicine Physician
APRN11009951FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Nov 17, 2021 Accepting new patients
Florida Clinical Practice Association Inc Family Medicine CurrentSince Nov 17, 2021 Accepting new patients

Locations

1549 Gale Lemerand Dr
Gainesville, FL 32610
Phone (352) 265-0496

9092 SW 70th Ln
Gainesville, FL 32608
Phone (352) 265-0335

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

2000 SW Archer Rd
Gainesville, FL 32608
Phone (352) 265-0287

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jwittlin141231@direct.shands.ufl.edu

Organizations & group practices 2

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 8

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": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1033718986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100226",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326104495",
            "telephone_number": "352-273-8656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 N Main St",
            "address_purpose": "LOCATION",
            "city": "Williston",
            "state": "FL",
            "postal_code": "326961705",
            "country_code": "US",
            "telephone_number": "352-528-0587",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23343 NW County Road 236",
            "address_purpose": "LOCATION",
            "city": "High Springs",
            "state": "FL",
            "postal_code": "326439669",
            "country_code": "US",
            "telephone_number": "352-463-4520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITTLIN",
        "first_name": "JASON",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-21",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "F09201237",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11009951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.