Individual provider Active NPI

Eduardo J Sequeira, MD

  • Internal Medicine Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1003890674
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0078293 Issued in FL
Practice address
79 Satinwood LN
Palm Beach Gardens, FL 33410-1601
Phone
(561) 889-7927
Fax
(772) 882-4931
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0078293 FL Primary

Addresses

Primary practice location

79 Satinwood LN
Palm Beach Gardens, FL 33410-1601

Mailing address

79 Satinwood LN
Palm Beach Gardens, FL 33410-1601
Phone (561) 889-7927

Other identifiers 1

IdentifierTypeStateIssuer
8024006MedicaidFL

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
I20080105000017 FL Practitioner - Internal Medicine 7911087754 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0078293FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Palm Beach Physician Group Inc CurrentSince Jan 1, 2012 Accepting new patients
Nursing Home Consultants LLC Internal Medicine Past Accepting new patients
Jersey City Medical Center Past Accepting new patients

Locations

800 Meadows Rd
Boca Raton, FL 33486
Phone (561) 395-7100

1710 Lucerne Ave
Lake Worth Beach, FL 33460
Phone (561) 582-1912

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

2939 S Haverhill Rd
West Palm Beach, FL 33415
Phone (561) 641-3130

1626 Davis Rd
West Palm Beach, FL 33406
Phone (561) 265-3525

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1003890674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 SATINWOOD LN",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334101601",
            "telephone_number": "561-889-7927",
            "fax_number": "772-882-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 SATINWOOD LN",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334101601",
            "telephone_number": "561-889-7927",
            "fax_number": "772-882-4931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEQUEIRA",
        "first_name": "EDUARDO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0078293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8024006",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.