Individual provider Active NPI

Elena Tioutiareva, APRN

  • Critical Care Medicine Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1609559400
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
APRN11027673 Issued in FL
Practice address
52 W Underwood St
Orlando, FL 32806-1110
Phone
(321) 841-5112
NPI assigned
Aug 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 11027673 FL
Critical Care Medicine Nurse Practitioner 363LC0200X APRN11027673 FL Primary

Addresses

Primary practice location

52 W Underwood St
Orlando, FL 32806-1110

Mailing address

1714 Magnolia Ave
South Daytona, FL 32119-1711
Phone (407) 242-5364

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
I20230928003652 FL Practitioner - Nurse Practitioner 8022462712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

52 W Underwood St
Orlando, FL 32806-1110
Phone (407) 841-5111

Hospital & facility affiliations

  • Orlando Health-Health Central Hospital Hospital, Ocoee, FL, CCN 100030
  • Orlando Health Hospital, Orlando, FL, CCN 100006

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11027673FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2023 Accepting new patients

Locations

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

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

52 Underwood St
Orlando, FL 32806
Phone (321) 841-3581

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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 3

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": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1609559400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 MAGNOLIA AVE",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191711",
            "telephone_number": "407-242-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 W UNDERWOOD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "321-841-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIOUTIAREVA",
        "first_name": "ELENA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11027673",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "FL",
            "license": "APRN11027673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.