NPIMap

Individual provider Active NPI

Andrew Boltuch, D.O.

  • Orthopaedic Surgery Physician
  • Clearwater, FL
National Provider Identifier
1265815450
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
OS15092 Issued in FL
Practice address
430 Morton Plant St Ste 301
Clearwater, FL 33756-3395
Phone
(727) 461-6026
NPI assigned
Jul 7, 2015
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X OS15092 FL Primary

Addresses

Primary practice location

430 Morton Plant St Ste 301
Clearwater, FL 33756-3395

Mailing address

5901 E Fowler Ave Ste 100
Temple Terrace, FL 33617-2305
Phone (813) 978-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200814001192 FL Practitioner - Orthopedic Surgery 3375969801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Specialists, LLPGroup PAC ID 2466446992, 10 clinicians

Practice addresses (Care Compare)

37026 US Hwy 19 N
Palm Harbor, FL 34684-1109
Phone (727) 938-1935

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)25
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS15092FLMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orthopedic Specialists, LLP Orthopaedic Surgery CurrentSince Apr 10, 2025 Accepting new patients
Bay Area Orthopaedic Specialists LLC Past Accepting new patients

Locations

37026 US Highway 19 N
Palm Harbor, FL 34684
Phone (727) 938-1935

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: aboltuch384104@orlandohealth.medalliesdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/GJHCBD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1265815450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 E FOWLER AVE STE 100",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336172305",
            "telephone_number": "813-978-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MORTON PLANT ST STE 301",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563395",
            "telephone_number": "727-461-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTUCH",
        "first_name": "ANDREW",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "OS15092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.