Individual provider Active NPI

Gladys Magdalena Ottenwalder, NP

  • Family Nurse Practitioner
  • New Port Richey, FL
National Provider Identifier
1740077890
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F03250639 Issued in FL
Practice address
8501 Little Rd
New Port Richey, FL 34654-4924
Phone
(727) 869-7755
Fax
(727) 869-7372
NPI assigned
Apr 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F03250639 FL Primary

Addresses

Primary practice location

8501 Little Rd
New Port Richey, FL 34654-4924

Mailing address

8501 Little Rd
New Port Richey, FL 34654-4924
Phone (727) 869-7755

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
I20250804003706 FL Practitioner - Nurse Practitioner 3577756584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunstate Healthcare LLCGroup PAC ID 7113210444, 6 clinicians

Practice addresses (Care Compare)

12120 Cortez Blvd
Brooksville, FL 34613-5514
Phone (352) 559-8849

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F03250639FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sunstate Healthcare LLC CurrentSince Jul 1, 2025 Accepting new patients
Optumcare Florida, LLC PastSince Jul 12, 2026 Accepting new patients
Optumcare Florida LLC PastSince Jul 12, 2026 Accepting new patients

Locations

12120 Cortez Blvd
Spring Hill, FL 34613
Phone (352) 559-8849

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 3

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": "1745280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1740077890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8501 LITTLE RD",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346544924",
            "telephone_number": "727-869-7755",
            "fax_number": "727-869-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 LITTLE RD",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346544924",
            "telephone_number": "727-869-7755",
            "fax_number": "727-869-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTENWALDER",
        "first_name": "GLADYS",
        "middle_name": "MAGDALENA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-22",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F03250639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.