Individual provider Active NPI

Joseph E Tienstra, MD

  • Diagnostic Radiology Physician
  • Fort Myers, FL
National Provider Identifier
1366499329
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME0045066 Issued in FL
Practice address
63 Barkley Cir
Ste. 100 & 101
Fort Myers, FL 33907-4514
Phone
(239) 938-3500
Fax
(239) 278-0055
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME0045066 FL Primary

Addresses

Primary practice location

63 Barkley Cir
Ste. 100 & 101
Fort Myers, FL 33907-4514

Mailing address

8791 Conference Dr
Suite 1
Fort Myers, FL 33919-5822
Phone (239) 938-3506

Other identifiers 6

IdentifierTypeStateIssuer
300064841OtherFLRR MEDICARE
205472OtherAMERIGROUP
0004093006OtherAETNA
ME45066OtherFL WC CERTIFICATION
O36234400MedicaidFL
36420OtherBCBSFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.94 of 100Reported as group
Quality
100
Improvement activities
40
Cost
79.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0045066FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System Past Accepting new patients
Morgan Medical Corp Diagnostic Radiology Past Accepting new patients
LMR Imaging Diagnostic Radiology Past Accepting new patients
Florida Foot and Ankle Physicians PA PastSince Aug 1, 1997 Accepting new patients
Charlotte Resources Inc Diagnostic Radiology Past Accepting new patients
Irbf Inc Past Accepting new patients
Irbf, Inc. PastSince Aug 1, 2005 Accepting new patients

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JHFHBA

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1366499329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8791 CONFERENCE DR",
            "address_2": "SUITE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195822",
            "telephone_number": "239-938-3506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 BARKLEY CIR",
            "address_2": "STE. 100 & 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074514",
            "telephone_number": "239-938-3500",
            "fax_number": "239-278-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIENSTRA",
        "first_name": "JOSEPH",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME0045066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "300064841",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "205472",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004093006",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL WC CERTIFICATION",
            "identifier": "ME45066",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "O36234400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "36420",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.