Individual provider Active NPI

Tina Kaur Thethi, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Orlando, FL
National Provider Identifier
1295849552
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME141391 Issued in FL
Practice address
2415 N Orange Ave Ste 502
Orlando, FL 32804-5503
Phone
(407) 303-2801
Fax
(407) 303-2805
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 15709R LA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME141391 FL Primary

Addresses

Primary practice location

2415 N Orange Ave Ste 502
Orlando, FL 32804-5503

Mailing address

2415 N Orange Ave Ste 502
Orlando, FL 32804-5503
Phone (407) 303-2801

Other identifiers 1

IdentifierTypeStateIssuer
1070840MedicaidLA

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
I20191101000066 FL Practitioner - Endocrinology 8921009051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1996
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 502
Orlando, FL 32804-5503
Phone (407) 303-2801

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Oct 14, 2019 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Oct 14, 2019 Accepting new patients
Administrators of the Tulane Education Fund PastSince Jul 31, 2023 Accepting new patients
The Administrators of the Tulane Educational Fund Past Accepting new patients

Locations

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

2415 N Orange Ave
Ste 502
Orlando, FL 32804
Phone (407) 303-2801

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: tthethi74030@adventhealth.direct-ci.com

Organizations & group practices 4

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1295849552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 N ORANGE AVE STE 502",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045503",
            "telephone_number": "407-303-2801",
            "fax_number": "407-303-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 N ORANGE AVE STE 502",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045503",
            "telephone_number": "407-303-2801",
            "fax_number": "407-303-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THETHI",
        "first_name": "TINA",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "LA",
            "license": "15709R",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME141391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1070840",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.