Paul Tartarilla, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN2897842 Issued in FL

Practice address

1005 Mar Walt Drive
Pediatric Department
Fort Walton Beach, FL 32547-6707

Phone

(850) 863-8203

Fax

(850) 863-8113

NPI assigned

Dec 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• White-Wilson Medical Center PA

  • Clinic/Center
  • Fort Walton Beach, FL
  • NPI 1467437277
  NPD

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1285610899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "address_2": "PEDIATRIC DEPARTMENT",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8203",
            "fax_number": "850-862-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DRIVE",
            "address_2": "PEDIATRIC DEPARTMENT",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8203",
            "fax_number": "850-863-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARTARILLA",
        "first_name": "PAUL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN2897842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "Y9978",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301514900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christyl M Tabb Garcia, MS
• Tactical Rehabilitation Inc
• Meghan K Takacs, PTA
• Cassandra Tang
• Tara Harden M.D., P.a.
• Mary Miller Tatum, M.ED, CCC-SLP
• Sherry Jane Tavarez, RN
• Michael E Tavernaris, M.D.
• Amanda Taylor, LMT
• Camella M Taylor

• Nurse Practitioner in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.