Individual provider Active NPI

Jillian Rae Foertsch

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1821814146
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11037463 Issued in FL
Practice address
1 Tampa General Cir
Tampa, FL 33606-3571
Phone
(813) 844-0000
NPI assigned
Dec 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN9522965 FL
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 11037463 FL
Nurse Practitioner 363L00000X 11037463 FL Primary

Addresses

Primary practice location

1 Tampa General Cir
Tampa, FL 33606-3571

Mailing address

10213 Cool Waterlily Ave
Riverview, FL 33578-4380
Phone (631) 487-5414

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
I20250217003018 FL Practitioner - Nurse Practitioner 7719407030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Florida College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 844-4396

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9522965FLMDCritical Care Medicine Registered Nurse
11037463FLMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Feb 24, 2025 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Feb 24, 2025 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Critical Care Medicine Current Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

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 1

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": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1821814146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10213 COOL WATERLILY AVE",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335784380",
            "telephone_number": "631-487-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TAMPA GENERAL CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "813-844-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOERTSCH",
        "first_name": "JILLIAN",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-02",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "RN9522965",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "FL",
            "license": "11037463",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11037463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.