Individual provider Active NPI

John Joseph Krutsick II, DO

  • Hospitalist Physician
  • Port Charlotte, FL
National Provider Identifier
1871052704
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
OS17419 Issued in FL
Practice address
21298 Olean Blvd
Port Charlotte, FL 33952-6765
Phone
(941) 629-1181
NPI assigned
Mar 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS17419 FL
Hospitalist Physician 208M00000X OS17419 FL Primary

Addresses

Primary practice location

21298 Olean Blvd
Port Charlotte, FL 33952-6765

Mailing address

21298 Olean Blvd
Port Charlotte, FL 33952-6765
Phone (941) 629-1181

Other practice location 1

6500 38th Ave N
St Petersburg, FL 33710-1629
Phone (727) 341-4919

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
I20240730000532 FL Practitioner - Family Practice 6800206541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of FL, LLCGroup PAC ID 9234596743, 513 clinicians

Practice addresses (Care Compare)

21298 Olean Blvd
Port Charlotte, FL 33952-6705
Phone (941) 629-1181

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS17419FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of FL, LLC Hospitalist CurrentSince Jun 17, 2024 Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

21298 Olean Blvd
Pt Charlotte, FL 33952
Phone (941) 624-7032

6500 38th Ave N
St Petersburg, FL 33710
Phone (727) 341-4870

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1871052704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21298 OLEAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526765",
            "telephone_number": "941-629-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21298 OLEAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526765",
            "telephone_number": "941-629-1181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6500 38th Ave N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337101629",
            "country_code": "US",
            "telephone_number": "727-341-4919",
            "fax_number": "727-341-4886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUTSICK",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS17419",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS17419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.