Individual provider Active NPI

Alyssa Rae Putzel, APRN

  • Family Nurse Practitioner
  • Saint Petersburg, FL
National Provider Identifier
1942850409
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11004139 Issued in FL
Practice address
5405 Park St N
Saint Petersburg, FL 33709-1044
Phone
(727) 547-8425
Fax
(813) 635-2699
NPI assigned
Sep 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11004139 FL Primary

Addresses

Primary practice location

5405 Park St N
Saint Petersburg, FL 33709-1044

Mailing address

5405 Park St N
Saint Petersburg, FL 33709-1044
Phone (275) 478-4257

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alyssa.doringAPRN@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

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
I20191212001171 FL Practitioner - Nurse Practitioner 7517390172 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

10799 Park Blvd
Seminole, FL 33772-5420
Phone (727) 315-5239

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

Hospital & facility affiliations

  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127
  • St Anthonys Hospital Hospital, Saint Petersburg, FL, CCN 100067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11004139FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Jan 13, 2023 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Jan 13, 2023 Accepting new patients
MCR Health, Inc. CurrentSince May 25, 2021 Accepting new patients
MCR Health, Inc. Family CurrentSince May 25, 2021 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

10799 Park Blvd
Seminole, FL 33772
Phone (727) 319-0180

5405 Park St N
St Petersburg, FL 33709
Phone (727) 544-1827

Interoperability endpoints

  • Direct secure messaging: alyssa.doringaprn@direct.mybaycare.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1942850409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 PARK ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337091044",
            "telephone_number": "275-478-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 PARK ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337091044",
            "telephone_number": "727-547-8425",
            "fax_number": "813-635-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTZEL",
        "first_name": "ALYSSA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-17",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11004139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alyssa.doringAPRN@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew St Fl 2",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337593012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

Verify at the official NPI Registry.