Chukwuka G Ayetin, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS17378 Issued in FL

Practice address

605 Lamar Ave
Brooksville, FL 34601-3211

Phone

(352) 796-9990

Fax

(352) 796-2226

NPI assigned

Apr 26, 2018

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Philadelphia College of Osteopathic Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

H2 Rehabilitation Services of Florida LLCGroup PAC ID 3971411851, shared by 10 NPIs, 257 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pinnacle Home Care of Spring Hill Inc Home health agency, Spring Hill, FL, CCN 108068

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: chukwuka.ayetin@wellmed.eclinicaldirectplus.com

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.

• Optumcare Florida LLC

  dba Optum

  • General Practice Physician
  • Tampa, FL
  • NPI 1053384214

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Optumcare Florida, LLC

  dba Optum

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1659884294
  NPD
• Optumcare Florida Ci, LLC

  • Primary Care Clinic/Center
  • Winter Park, FL
  • NPI 1720506603
  NPD (past)
• Wellmed Medical Management of Florida Inc

  • Family Medicine Physician
  • Port St Lucie, FL
  • NPI 1033395397
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pinnacle Home Care of Spring Hill, LLC.

  dba Pinnacle Home Care

  • Home Health Agency
  • Spring Hill, FL
  • NPI 1467488999
  Care Compare affiliation

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1508354432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 SUNFOREST DR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346327",
            "telephone_number": "727-824-0780",
            "fax_number": "813-514-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 LAMAR AVE",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346013211",
            "telephone_number": "352-796-9990",
            "fax_number": "352-796-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYETIN",
        "first_name": "CHUKWUKA",
        "middle_name": "G",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-26",
        "last_updated": "2023-03-07",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS17378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110907100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Auro Management LLC
• Michelle S Avalos, MD
• Avinash L. Jadhav MD, PA (Orthopedic Specialist MD)
• Awp Service Solutions
• Axzelant LLC
• Azzam Muftah MD PA
• Jennifer Nicole Azzariti, DENTAL HYGIENIST
• Stacey C Azzolino, PA
• Scott Lamar Babcock, CRNA
• Brandon Shayan Badamtchian

• Family Medicine Physician in Brooksville, FL
• Providers in Brooksville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.