Individual provider Active NPI

Tiji Kuthathayil Joseph

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1114575248
Registry record updated Sep 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11001045 Issued in FL
Practice address
601 E Rollins St
Orlando, FL 32803-1248
Phone
(407) 303-5600
NPI assigned
Sep 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2019

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 APRN11001045 FL Primary

Addresses

Primary practice location

601 E Rollins St
Orlando, FL 32803-1248

Mailing address

4532 Village Wood Dr
Orlando, FL 32835-2728
Phone (407) 456-3472

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
I20201118000503 FL Practitioner - Nurse Practitioner 0749691087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2415 N Orange Ave
Suite 200
Orlando, FL 32804-5505
Phone (407) 303-1812

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11001045FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Dec 7, 2020 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Dec 7, 2020 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

2415 N Orange Ave
Ste 200
Orlando, FL 32804
Phone (407) 303-1812

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: tjoseph137183@adventhealth.direct-ci.com

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 2

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": "1567382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567382400000",
    "number": "1114575248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4532 VILLAGE WOOD DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328352728",
            "telephone_number": "407-456-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-303-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "TIJI",
        "middle_name": "KUTHATHAYIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-02",
        "last_updated": "2019-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11001045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.