Individual provider Active NPI

Jennifer Tutanes, ACNP-BC

  • Neurology Physician
  • Fort Myers, FL
National Provider Identifier
1457629859
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
APRN11021029 Issued in FL
Practice address
11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206
Phone
(239) 208-2212
NPI assigned
Dec 13, 2011
Last updated
Jan 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X APRN11021029 FL Primary
Acute Care Nurse Practitioner 363LA2100X 714442 TX

Addresses

Primary practice location

11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206

Mailing address

11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206

Other practice location 1

22999 Highway 59 N
Kingwood, TX 77339-4412
Phone (281) 348-8989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140228000718 TX Practitioner - Nurse Practitioner 1658501119 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. David's Ortho Neuro and Rehab PLLCGroup PAC ID 5799948857, 60 clinicians

Practice addresses (Care Compare)

1015 E 32ND St
Suite 407
Austin, TX 78705-2701
Phone (512) 544-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11021029FLMDNeurology Physician
714442TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Healthcare Services of Texas, PLLC Neurology CurrentSince Oct 1, 2018 Accepting new patients
Lonestar Hospital Medicine Associates, PA CurrentSince Sep 1, 2018 Accepting new patients
Neurotexas, PLLC PastSince Jan 10, 2017 Accepting new patients
Surgeons Who Only Care for Kids, PA PastSince Sep 1, 2018 Accepting new patients
St Davids Heart & Vascular, PLLC Past Accepting new patients

Locations

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

22999 Highway 59 N
Kingwood, TX 77339
Phone (281) 348-3322

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1323734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1457629859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11215 METRO PKWY STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11215 METRO PKWY STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661206",
            "telephone_number": "239-208-2212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22999 Highway 59 N",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "773394412",
            "country_code": "US",
            "telephone_number": "281-348-8989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUTANES",
        "first_name": "JENNIFER",
        "credential": "ACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-13",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "APRN11021029",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "714442",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.