Individual provider Active NPI

Justin M Tello

  • Chiropractor
  • Land O' Lakes, FL
National Provider Identifier
1770134132
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12893 Issued in FL
Practice address
5420 Land O' Lakes Blvd Suite 105
Land O' Lakes, FL 34639
Phone
(813) 996-9800
Fax
(813) 874-0471
NPI assigned
Sep 26, 2019
Last updated
Dec 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12893 FL Primary

Addresses

Primary practice location

5420 Land O' Lakes Blvd Suite 105
Land O' Lakes, FL 34639

Mailing address

5420 Land O' Lakes Blvd Suite 105
Land O' Lakes, FL 34639
Phone (727) 365-7674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220810000107 FL Practitioner - Chiropractic 7810370707 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5420 Land O Lakes Blvd
Suite 105
Land O Lakes, FL 34639-3101

5420 Land O Lakes Blvd
Suite 105
Land O Lakes, FL 34639-3401
Phone (813) 996-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12893FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Shawn Hanson DC, PA Chiropractor CurrentSince Jul 25, 2022 Accepting new patients
Frank Clinic of Chiropractic PA Chiropractor CurrentSince Jun 28, 2024 Accepting new patients
Brenda Karina Lopez LLC CurrentSince Jun 28, 2024 Accepting new patients
Justin Tello DC PA Inc Chiropractor CurrentSince Aug 21, 2025 Accepting new patients

Locations

5420 Land O Lakes Blvd
Ste 105
Land O Lakes, FL 34639
Phone (813) 996-9800

1883 S Pinellas Ave
Tarpon Springs, FL 34689
Phone (727) 937-6740

38040 Daughtery Rd
Zephyrhills, FL 33540
Phone (813) 713-6499

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": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1770134132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 LAND O' LAKES BLVD SUITE 105",
            "city": "LAND O' LAKES",
            "state": "FL",
            "postal_code": "34639",
            "telephone_number": "727-365-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 LAND O' LAKES BLVD SUITE 105",
            "city": "LAND O' LAKES",
            "state": "FL",
            "postal_code": "34639",
            "telephone_number": "813-996-9800",
            "fax_number": "813-874-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLO",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-26",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "12893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Land O' Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.