Jennifer Lee Tulli, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9104122 Issued in FL

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-3003

Phone

(352) 265-2504

NPI assigned

Apr 11, 2007

Last updated

Oct 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Florida Clinical Practice Association Inc

  dba UF Health Physicians

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• Florida Clinical Practice Association Inc

  dba UF Health Family Medicine Ocala Heath Brook

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD
• Cardiac and Thoracic Surgery Associates

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • York, PA
  • NPI 1689627259
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602374400000",
    "number": "1669695037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100129",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100129",
            "telephone_number": "352-273-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLI",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-10-11",
        "certification_date": "2020-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9104122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292801900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lani Hope Tudor-Dodd
• Vickie Lynn Tuell, RMHCI
• Michael J Tueth, MD
• Jimeka T Tuggerson
• Sonal S Tuli, MD
• Mark A Tulli, MD
• Noel Tullis
• Jonathan Tuma
• Lisa C Tumarkin, M.D.
• Kubra Melek Tuna, MD

• Surgical Physician Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.