Individual provider Active NPI

Todd E Chenicek, ARNP

  • Nurse Practitioner
  • Tallahassee, FL
National Provider Identifier
1437100724
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP 2941072 Issued in FL
Practice address
2400 Miccosukee Rd
Tallahassee, FL 32308-5314
Phone
(850) 877-2105
Fax
(850) 216-1321
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP 2941072 FL Primary

Addresses

Primary practice location

2400 Miccosukee Rd
Tallahassee, FL 32308-5314

Mailing address

2400 Miccosukee Rd
Tallahassee, FL 32308-5314
Phone (850) 877-2105

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050810000372 FL Practitioner - Nurse Practitioner 5890724876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stockwell Reisman Paulk and Taylor PAGroup PAC ID 8628054053, 16 clinicians

Practice addresses (Care Compare)

2400 Miccosukee Rd
Tallahassee, FL 32308-5314
Phone (850) 877-2105

Hospital & facility affiliations

  • Doctors Memorial Hospital Inc Hospital, Perry, FL, CCN 101314

Merit-based Incentive Payment System (MIPS)

Final score
91.5 of 100Reported as group
Promoting interoperability
90
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 2941072FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stockwell Reisman Paulk & Taylor PA CurrentSince Jul 25, 2005 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1820 Riggins Rd
Ste 1
Tallahassee, FL 32308
Phone (850) 545-9376

2400 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 205-8404

Organizations & group practices 2

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 1

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1437100724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 MICCOSUKEE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085314",
            "telephone_number": "850-877-2105",
            "fax_number": "850-216-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MICCOSUKEE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085314",
            "telephone_number": "850-877-2105",
            "fax_number": "850-216-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENICEK",
        "first_name": "TODD",
        "middle_name": "E",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 2941072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.