Jeanette Tuller, MMS, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

9109893 Issued in FL

Practice address

2307 W Broward Blvd Ste 200
Fort Lauderdale, FL 33312-1420

Phone

(954) 792-1010

Fax

(954) 792-1199

NPI assigned

Sep 27, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Tenet Florida Physician Services II, LLCGroup PAC ID 1456507698, 99 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Broward Health North Hospital, Deerfield Beach, FL, CCN 100086

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jtuller2019970@direct.trinity-health.org

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.

• Tenet Florida Physician Services II, LLC

  • Orthopaedic Surgery Physician
  • West Palm Beach, FL
  • NPI 1912266420

  Medical

  Medicare reassignment Care Compare group NPD
• JT Medical Assist, LLC

  • Surgical Physician Assistant
  • Coconut Creek, FL
  • NPI 1891478525
  Medicare reassignment Authorized official
• Holy Cross Hospital Inc

  • Internal Medicine Physician
  • Ft. Lauderdale, FL
  • NPI 1467401877
  Medicare reassignment NPD
• Holy Cross Hospital, Inc

  • Health & Wellness Coach
  • Oakland Park, FL
  • NPI 1063207595
  NPD
• Tenet Florida Physician Services II, LLC

  • Durable Medical Equipment & Medical Supplies
  • Boca Raton, FL
  • NPI 1770391286
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Broward Hospital District

  • General Acute Care Hospital
  • Pompano Beach, FL
  • NPI 1376571323
  Care Compare affiliation
• North Broward Hospital District

  • Emergency Care Clinic/Center
  • Lighthouse Point, FL
  • NPI 1720936792

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1255880696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4948 NW 49TH CT",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 W BROWARD BLVD STE 200",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333121420",
            "telephone_number": "954-792-1010",
            "fax_number": "954-792-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLER",
        "first_name": "JEANETTE",
        "name_prefix": "Mrs.",
        "credential": "MMS, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9109893",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9109893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ladonna Sue Tucker, PTA
• Neil Thomas Tucker, MD
• Taheera Tucker
• Carrie Tudy
• Dana A Tufo
• Karen Tulloch
• Moreno Tulloch
• Brian Tulowitzki
• Parker Tunnell, PA-C
• Chinyere Tunsill

• Surgical Physician Assistant in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.