Individual provider Active NPI

T Terry Chutinan, M.D.

  • Surgery Physician
  • Altamonte Springs, FL
National Provider Identifier
1295767697
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME23398 Issued in FL
Practice address
800 N State Road 434
Suite 4
Altamonte Springs, FL 32714-7041
Phone
(407) 862-4242
Fax
(407) 862-9616
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME23398 FL Primary

Addresses

Primary practice location

800 N State Road 434
Suite 4
Altamonte Springs, FL 32714-7041

Mailing address

800 N State Road 434
Suite 4
Altamonte Springs, FL 32714-7041
Phone (407) 862-4242

Other identifiers 2

IdentifierTypeStateIssuer
48736OtherFLBCBS
051371700MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100317000407 FL Practitioner - General SurgeryPractitioner - Family Practice 8921133802

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME23398FLMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1295767697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N STATE ROAD 434",
            "address_2": "SUITE 4",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147041",
            "telephone_number": "407-862-4242",
            "fax_number": "407-862-9616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N STATE ROAD 434",
            "address_2": "SUITE 4",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147041",
            "telephone_number": "407-862-4242",
            "fax_number": "407-862-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUTINAN",
        "first_name": "T",
        "middle_name": "TERRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME23398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "48736",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051371700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.