Individual provider Active NPI

Tajinder Kaur Tut

  • Family Nurse Practitioner
  • Victorville, CA
National Provider Identifier
1053820712
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95026129 Issued in CA
Practice address
12830 Hesperia Rd
Victorville, CA 92395-7788
Phone
(760) 684-8999
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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 95026129 CA Primary

Addresses

Primary practice location

12830 Hesperia Rd
Victorville, CA 92395-7788

Mailing address

3881 S Sunrise Ave
Ontario, CA 91761-2755
Phone (317) 828-6588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95026129CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tobias Moeller-Bertram MD Corporation CurrentSince Jun 23, 2025 Accepting new patients

Locations

44630 Monterey Ave
Ste 100
Palm Desert, CA 92260
Phone (760) 340-4290

12830 Hesperia Rd
Ste C
Victorville, CA 92395
Phone (760) 684-8999

12830 Hesperia Rd
Victorville, CA 92395
Phone (760) 684-8999

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1053820712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3881 S SUNRISE AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917612755",
            "telephone_number": "317-828-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12830 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957788",
            "telephone_number": "760-684-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUT",
        "first_name": "TAJINDER",
        "middle_name": "KAUR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95026129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.