Individual provider Active NPI

Tabitha Elizabeth Bruinsma, ARNP

  • Adult Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1629578083
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN9284474 Issued in FL
Practice address
76 Underwood St Ste 200
Orlando, FL 32806-1110
Phone
(218) 412-8003
Fax
(321) 843-8777
NPI assigned
Feb 12, 2018
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN9284474 FL Primary
Family Nurse Practitioner 363LF0000X ARNP9284474 FL

Addresses

Primary practice location

76 Underwood St Ste 200
Orlando, FL 32806-1110

Mailing address

76 Underwood St Ste 200
Orlando, FL 32806-1110
Phone (321) 841-2800

Other identifiers 1

IdentifierTypeStateIssuer
ARNP9284474OtherFLSTATE OF FLORIDA DEPARTMENT OF HEALTH

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
I20180608001955 FL Practitioner - Nurse Practitioner 4789939000 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
Telehealth
Offers telehealth services
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

76 W Underwood St
Suite 100
Orlando, FL 32806-1110
Phone (321) 841-1570

Hospital & facility affiliations

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9284474FLMDAdult Health Nurse Practitioner
ARNP9284474FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Med-Psych Consultants LLC CurrentSince Jul 29, 2020 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jun 1, 2024 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jun 1, 2024 Accepting new patients
Orlando Inpatient Medicine, PA CurrentSince Jul 29, 2020 Accepting new patients

Locations

1507 S Hiawassee Rd
Ste 107
Orlando, FL 32835
Phone (407) 445-9545

1507 S Hiawassee Rd
Ste 206
Orlando, FL 32835
Phone (407) 445-9545

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

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

76 Underwood St
Ste 100
Orlando, FL 32806
Phone (321) 841-1570

76 Underwood St
Ste 200
Orlando, FL 32806
Phone (321) 841-2800

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1629578083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 UNDERWOOD ST STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "321-841-2800",
            "fax_number": "321-843-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 UNDERWOOD ST STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "218-412-8003",
            "fax_number": "321-843-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUINSMA",
        "first_name": "TABITHA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9284474",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9284474",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "ARNP9284474",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.