Individual provider Active NPI

Jeffrey L Puretz, MD

  • Obstetrics & Gynecology Physician
  • Lakeland, FL
National Provider Identifier
1811964687
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME0061645 Issued in FL
Practice address
1733 Lakeland Hills Blvd
Lakeland, FL 33805-3016
Phone
(813) 688-1528
Fax
(813) 577-1949
NPI assigned
Mar 1, 2006
Last updated
Jun 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME0061645 FL Primary

Addresses

Primary practice location

1733 Lakeland Hills Blvd
Lakeland, FL 33805-3016

Mailing address

PO Box 748817
Atlanta, GA 30374-8817
Phone (813) 286-0033

Other identifiers 1

IdentifierTypeStateIssuer
370199900MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080715000027 FL Practitioner - Obstetrics/Gynecology 3870666530 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Miami, LM Miller School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Care Florida LLCGroup PAC ID 9234031444, 324 clinicians

Practice addresses (Care Compare)

1733 Lakeland Hills Blvd
Lakeland, FL 33805-3016
Phone (863) 688-1528

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0061645FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Care Florida LLC Obstetrics & Gynecology CurrentSince Feb 1, 2009 Accepting new patients
Womens' Health Hospitalists, LLC Obstetrics & Gynecology CurrentSince Feb 20, 2018 Accepting new patients
Suncoast Community Health Centers Inc CurrentSince Jul 1, 2018 Accepting new patients
Suncoast Community Health Centers, Inc CurrentSince Jul 1, 2018 Accepting new patients

Locations

1729 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 686-0082

1733 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 688-1528

4690 Exploration Ave
#4692
Lakeland, FL 33812
Phone (863) 688-1528

13110 Elk Mountain Dr
Riverview, FL 33579
Phone (813) 349-7567

2814 14th Ave SE
Ruskin, FL 33570
Phone (813) 349-7800

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

5002 W Lemon St
Tampa, FL 33609

Interoperability endpoints

  • Direct secure messaging: jeffrey.puretz@wcfnf.eclinicaldirectplus.com

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1811964687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053016",
            "telephone_number": "813-688-1528",
            "fax_number": "813-577-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURETZ",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME0061645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370199900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.