Individual provider Active NPI

Santhia Mirtyl, APRN

  • Adult Health Nurse Practitioner
  • Temple Terrace, FL
National Provider Identifier
1609368950
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN9373212 Issued in FL
Practice address
13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926
Phone
(813) 779-6303
Fax
(786) 868-0012
NPI assigned
Jun 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN9373212 FL
Adult Health Nurse Practitioner 363LA2200X APRN9373212 FL Primary

Addresses

Primary practice location

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926

Mailing address

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926
Phone (813) 779-6303

Other practice location 1

4129 N Armenia Ave Ste B
Tampa, FL 33607-6436
Phone (813) 879-3699

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
I20181203000929 FL Practitioner - Nurse Practitioner 2466796479 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260

Hospital & facility affiliations

  • AdventHealth Carrollwood Hospital, Tampa, FL, CCN 100069

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System-Sunbelt Inc CurrentSince Sep 2, 2021 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Sep 2, 2021 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Sep 2, 2021 Accepting new patients
Tampa Lung Specialists, P.a. CurrentSince Oct 8, 2018 Accepting new patients
Florida Hospital Physician Group Inc CurrentSince Sep 2, 2021 Accepting new patients
Raul Sierra MD PA Past Accepting new patients

Locations

1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

4129 N Armenia Ave
Tampa, FL 33607
Phone (813) 870-3342

4129 N Armenia Ave
Ste B
Tampa, FL 33607
Phone (813) 877-7526

13067 N Telecom Pkwy
Temple Terrace, FL 33637
Phone (813) 333-9108

522 Carlton St
Wauchula, FL 33873
Phone (863) 773-0975

735 S 5th Ave
Wauchula, FL 33873
Phone (863) 402-3402

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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 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": "1527897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1609368950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13067 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370926",
            "telephone_number": "813-779-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13067 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370926",
            "telephone_number": "813-779-6303",
            "fax_number": "786-868-0012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4129 N Armenia Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076436",
            "country_code": "US",
            "telephone_number": "813-879-3699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRTYL",
        "first_name": "SANTHIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-02",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9373212",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9373212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.