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KIMBERLY JO TUTTLE PA
NPI 1558560995
Physician Assistant - Medical in Canandaigua, NY

Active since July 16, 2007PECOS Enrolled
495 N MAIN ST, CANANDAIGUA, NY 14424(585) 393-3515(585) 393-3515 Get Directions Write a Review

NPPES record last updated: July 28, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kimberly Jo Tuttle Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY JO TUTTLE PA (NPI 1558560995) is an individual medical provider in Canandaigua, New York and active in the NPI registry since July 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558560995
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameKIMBERLY JO TUTTLECredential: PA
Location Address495 N MAIN STCanandaigua, NY 14424-1283
Mailing Address495 N Main StCanandaigua, NY 14424-1283 · (585) 393-3515
Phone(585) 393-3515
Fax(585) 393-3515
Sole ProprietorNo
Enumeration DateJuly 16, 2007
Last NPPES UpdateJuly 28, 2016
✔ NPI 1558560995 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
495 N MAIN ST, Canandaigua, NY 14424
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Other Names 1

Former Name (1)Kimberly Jo Willis

Other Identifiers 2

Medicaid03385908NY
Medicare PINJ100058113NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly Jo Tuttle Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATIE MCMILLEN PA
Family Medicine
495 N MAIN ST
CANANDAIGUA, NY 14424
Ontario County (585) 393-3515
FARMINGTON FAMILY PRACTICE PC
Family Medicine
495 N MAIN ST
CANANDAIGUA, NY 14424
Ontario County (585) 393-3515
NANCY M ALLISON NP
Nurse Practitioner (Family)
495 N MAIN ST, FARMINGTON FAMILY PRACTICE
CANANDAIGUA, NY 14424
Ontario County (585) 393-3515
RUTH C SHEEHAN RNFNP
Nurse Practitioner (Family)
495 N MAIN ST
CANANDAIGUA, NY 14424
Ontario County (585) 393-3515

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Tuttle's NPI number?

The NPI number for Kimberly Tuttle is 1558560995. It was assigned to this individual provider in the NPPES registry on July 16, 2007. The provider is also known as Kimberly Jo Willis.

Where is Kimberly Tuttle located?

Kimberly Tuttle practices at 495 N Main St, Canandaigua, NY 14424. The listed phone number is (585) 393-3515.

What is Kimberly Tuttle's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Kimberly Tuttle enrolled in Medicare?

Yes. Kimberly Tuttle is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kimberly Tuttle was last updated on July 28, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.