Individual provider Active NPI

Jean-Robert Myrthil, ARNP

  • Gerontology Nurse Practitioner
  • Maitland, FL
National Provider Identifier
1477065746
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN9179887 Issued in FL
Practice address
2201 Lucien Way Ste 1000
Maitland, FL 32751-7003
Phone
(407) 875-0028
NPI assigned
Oct 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN9179887 FL Primary

Addresses

Primary practice location

2201 Lucien Way Ste 1000
Maitland, FL 32751-7003

Mailing address

2201 Lucien Way Ste 1000
Maitland, FL 32751-7003
Phone (407) 875-0028

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referral@vitas.direct.kno2fy.com VITAS Solutions Inc

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
I20191021000971 FL Practitioner - Nurse Practitioner 0749533248 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9179887FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Oct 23, 2019 Accepting new patients
Vitas Solutions Inc CurrentSince Jun 21, 2019 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 23, 2019 Accepting new patients

Locations

2201 Lucien Way
Ste 200
Maitland, FL 32751
Phone (407) 935-1192

3720 Executive Way
Miramar, FL 33025

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1400 S Orange Ave
Orlando, FL 32806
Phone (321) 841-1893

255 E 5th St
Ste 1050
Cincinnati, OH 45202

Interoperability endpoints

  • Direct secure messaging: jmyrthil871375@adventhealth.direct-ci.com
  • Direct secure messaging: referral@vitas.direct.kno2fy.com

Organizations & group practices 3

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": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1477065746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 LUCIEN WAY STE 1000",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517003",
            "telephone_number": "407-875-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 LUCIEN WAY STE 1000",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517003",
            "telephone_number": "407-875-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYRTHIL",
        "first_name": "JEAN-ROBERT",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-26",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9179887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referral@vitas.direct.kno2fy.com",
            "affiliation": "Y",
            "affiliationName": "VITAS Solutions Inc",
            "address_1": "3720 Executive Way",
            "city": "Miramar",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330253946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.