Individual provider Active NPI

Richard S Tuttle, MD

  • Physical Medicine & Rehabilitation Physician
  • Arlington HTS, IL
National Provider Identifier
1679554034
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
036088155 Issued in IL
Practice address
3030 W Salt Creek LN
Suite 100
Arlington HTS, IL 60005-5001
Phone
(847) 870-4200
Fax
(847) 870-0059
NPI assigned
Nov 10, 2005
Last updated
Jun 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 036088155 IL Primary

Addresses

Primary practice location

3030 W Salt Creek LN
Suite 100
Arlington HTS, IL 60005-5001

Mailing address

3030 W Salt Creek LN
Suite 100
Arlington HTS, IL 60005-5001
Phone (847) 870-4200

Other identifiers 2

IdentifierTypeStateIssuer
0360881551MedicaidIL
01634499OtherILBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100224000921 IL Practitioner - Orthopedic Surgery 6002950391
I20220830003971 FL Practitioner - Physical Medicine and Rehabilitation 6002950391 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036088155ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Ann Brown DO PA Physical Medicine & Rehabilitation CurrentSince Jun 16, 2022 Accepting new patients
Illinois Bone and Joint Institute, LLC Past Accepting new patients
Northwest Orthopedic Surgery, S.C. Past Accepting new patients
Northwest Orthopedic Surgery SC Past Accepting new patients

Locations

920 S Myrtle Ave
Unit B
Clearwater, FL 33756
Phone (727) 210-2225

1022 Main St
Ste M
Dunedin, FL 34698
Phone (727) 210-2225

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.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1679554034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 W SALT CREEK LN",
            "address_2": "SUITE 100",
            "city": "ARLINGTON HTS",
            "state": "IL",
            "postal_code": "600055001",
            "telephone_number": "847-870-4200",
            "fax_number": "847-870-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 W SALT CREEK LN",
            "address_2": "SUITE 100",
            "city": "ARLINGTON HTS",
            "state": "IL",
            "postal_code": "600055001",
            "telephone_number": "847-870-4200",
            "fax_number": "847-870-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTLE",
        "first_name": "RICHARD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036088155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360881551",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01634499",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington HTS, IL

Sources for this page

Verify at the official NPI Registry.