NPIMap

Organization Active NPI

Medical Center of Deltona, Inc.

Doing business as Halifax Health UF Health - Medical Center of Deltona

  • General Acute Care Hospital
  • Deltona, FL
National Provider Identifier
1003465097
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
MEDICAL CENTER OF DELTONA, INC.
Doing business as
Halifax Health UF Health - Medical Center of Deltona
Practice address
3300 Halifax Crossings Blvd.
Deltona, FL 32725
Phone
(386) 254-4000
NPI assigned
Sep 11, 2019
Last updated
Jun 22, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
HALIFAX HOSPITAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Authorized official

Name
Eric M Peburn
Title
Cfo
Phone
(386) 425-4568

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

3300 Halifax Crossings Blvd.
Deltona, FL 32725

Mailing address

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2700
Phone (386) 254-4000

Other names 1

  • Halifax Health UF Health - Medical Center of Deltona Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191016001487 FL Part A Provider - Hospital 0446581813 Practice locations: Deltona, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003465097. Details of each certification follow.

Hospital certification: CCN 100330

Legal name
MEDICAL CENTER OF DELTONA, INC.
Doing business as
HALIFAX HEALTH UF HEALTH MEDICAL CENTER OF DELTONA
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Mar 12, 2020
Last certification
Sep 17, 2020
Beds
42
Ownership / control type
Local
Organization structure
CorporationNon-profit
Incorporated
Jul 18, 2019 in FL
Enrollment address
3300 Halifax Crossings Blvd
Deltona, FL 32725-2911
Other Hospital Practice Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Halifax Health /Uf Health Medical Center of DeltonCCN 100330 · All quality measures
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2123667Medical Center of Deltona, Inc3300 Halifax Crossing Blvd, Deltona, FL 32725AccreditationMay 29, 2028
10D2174989Medical Center of Deltona3300 Halifax Crossing Blvd Suite1B-176, Deltona, FL 32725AccreditationAug 11, 2026

National Provider Directory

National Provider Directory
Part of
Federico C Vinas MD

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3400 E Halifax Crossing Blvd
Ste 120
Deltona, FL 32725

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jeffrey Feasel Individual Corporate OfficerCeo and Board Member Jul 18, 2019
Corporate DirectorCeo and Board Member Sep 9, 2019
Operational/Managerial ControlCeo and Board Member Jul 18, 2019
Andrea Kurak Individual Corporate DirectorBoard Member Sep 9, 2019
Halifax Hospital Medical Center Organization, Daytona Beach, FL 5% Or Greater Direct Ownership Interest Jul 18, 2019
Operational/Managerial Control Dec 10, 2019 50%
Shawn Remington Individual Corporate OfficerCfo Dec 18, 2023
W-2 Managing EmployeeCfo Dec 18, 2023

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 151

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 151

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592784000000",
    "number": "1003465097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142700",
            "telephone_number": "386-254-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 HALIFAX CROSSINGS BLVD.",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "32725",
            "telephone_number": "386-254-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER OF DELTONA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HALIFAX HOSPITAL MEDICAL CENTER",
        "enumeration_date": "2019-09-11",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A",
        "authorized_official_last_name": "PEBURN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "386-425-4568"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Halifax Health UF Health - Medical Center of Deltona",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Halifax Health UF Health - Medical Center of Deltona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deltona, FL

Sources for this page

Verify at the official NPI Registry.