Individual provider Active NPI

Tabby Ndanu Tuitoek, NP

  • Gerontology Nurse Practitioner
  • Shawnee, KS
National Provider Identifier
1942059589
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
83019 Issued in KS
Practice address
6345 Long Ave
Shawnee, KS 66216-2504
Phone
(913) 631-6400
NPI assigned
May 16, 2024
Last updated
May 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 83019 KS Primary

Addresses

Primary practice location

6345 Long Ave
Shawnee, KS 66216-2504

Mailing address

6345 Long Ave
Shawnee, KS 66216-2504
Phone (913) 631-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20241031000341 KS Practitioner - Nurse Practitioner 6204369119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmeri Family Medicine Associates PAGroup PAC ID 5496982779, 7 clinicians

Practice addresses (Care Compare)

6345 Long Ave
Shawnee, KS 66216-2504
Phone (913) 631-6400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83019KSMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Springs LLC Gerontology Current Accepting new patients
Palmeri Family Medicine Associates PA CurrentSince Aug 22, 2024 Accepting new patients

Locations

6345 Long Ave
Shawnee Msn, KS 66216
Phone (913) 631-6400

Organizations & group practices 2

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": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1942059589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6345 LONG AVE",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662162504",
            "telephone_number": "913-631-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6345 LONG AVE",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662162504",
            "telephone_number": "913-631-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUITOEK",
        "first_name": "TABBY",
        "middle_name": "NDANU",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KS",
            "license": "83019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

Verify at the official NPI Registry.