Individual provider Active NPI

Middey Damian, M.D.

  • Pediatric Endocrinology Physician
  • Wellington, FL
National Provider Identifier
1013938422
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
ME93081 Issued in FL
Practice address
1447 Medical Park Blvd Ste 104
Wellington, FL 33414-3164
Phone
(561) 792-1525
Fax
(561) 792-1521
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X ME93081 FL Primary

Addresses

Primary practice location

1447 Medical Park Blvd Ste 104
Wellington, FL 33414-3164

Mailing address

1447 Medical Park Blvd Ste 104
Wellington, FL 33414-3164
Phone (561) 792-1525

Other identifiers 1

IdentifierTypeStateIssuer
275246800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME93081FLMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Endocrine & Diabetes Care Inc Pediatric Endocrinology CurrentSince Sep 29, 2024 Accepting new patients

Locations

1447 Medical Park Blvd
Ste 104
Wellington, FL 33414
Phone (561) 792-1525

10111 Forest Hill Blvd
Rm 251
Wellington, FL 33414
Phone (561) 204-1428

Organizations & group practices 1

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1013938422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 MEDICAL PARK BLVD STE 104",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143164",
            "telephone_number": "561-792-1525",
            "fax_number": "561-792-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 MEDICAL PARK BLVD STE 104",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143164",
            "telephone_number": "561-792-1525",
            "fax_number": "561-792-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMIAN",
        "first_name": "MIDDEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "FL",
            "license": "ME93081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275246800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.