Individual provider Active NPI

John Paul Tutela, MD

  • Plastic Surgery Physician
  • New York, NY
National Provider Identifier
1477878205
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
25MA09369900 Issued in NJ
Practice address
30 W 60TH St
Suite an
New York, NY 10023-7902
Phone
(917) 912-1677
NPI assigned
Apr 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 252127 NY
Plastic Surgery Physician 208200000X 25MA09369900 NJ Primary

Addresses

Primary practice location

30 W 60TH St
Suite an
New York, NY 10023-7902

Mailing address

30 W 60TH St
Suite an
New York, NY 10023-7902
Phone (917) 912-1677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20140723001658 NJ Practitioner - Plastic and Reconstructive Surgery 5991921231

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Rutgers New Jersey Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 S Orange Ave
Livingston, NJ 07039-5817

614 Middle Country Rd
Middle Island, NY 11953-2522

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tutela Plastic Surgery PA Plastic Surgery Past Accepting new patients

Organizations & group practices 1

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": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1477878205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W 60TH ST",
            "address_2": "SUITE AN",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237902",
            "telephone_number": "917-912-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W 60TH ST",
            "address_2": "SUITE AN",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237902",
            "telephone_number": "917-912-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTELA",
        "first_name": "JOHN PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-05",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "252127",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "25MA09369900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.