Individual provider Active NPI

David Harris, MD

  • Anesthesiology Physician
  • Palm City, FL
National Provider Identifier
1013961374
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME61067 Issued in FL
Practice address
2381 SW Racquet Club Dr
Palm City, FL 34990-2608
Phone
(772) 418-2036
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME61067 FL Primary
Anesthesiology Physician 207L00000X 2009-00912 NC

Addresses

Primary practice location

2381 SW Racquet Club Dr
Palm City, FL 34990-2608

Mailing address

2381 SW Racquet Club Dr
Palm City, FL 34990-2608

Other identifiers 2

IdentifierTypeStateIssuer
14919OtherFLBCBS OF FLORIDA
377132600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20091118000064 FL Practitioner - Anesthesiology 9234159542 Reassigns benefits to 2 organizations
I20170207002331 NC Practitioner - Anesthesiology 9234159542
I20170411000044 NY Practitioner - Anesthesiology 9234159542 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0043395FLMDAnesthesiology Physician
ME61067FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp, Inc. Anesthesiology CurrentSince Oct 1, 2015 Accepting new patients
St. Lucie Anesthesia Associates, LLC Anesthesiology CurrentSince Feb 3, 2016 Accepting new patients
Sheridan Healthcorp Inc Anesthesiology Current Accepting new patients
St Lucie Anesthesia Associates LLC Anesthesiology CurrentSince Feb 3, 2016 Accepting new patients
Sheridan Healthcorp Inc Anesthesiology CurrentSince Oct 1, 2015 Accepting new patients
Premier Anesthesia of New York, P.C. Anesthesiology CurrentSince Mar 1, 2017 Accepting new patients
Surgery Center of Okeechobee, LLC Past Accepting new patients
Martin County Pain Clinic PL PastSince Sep 22, 2005 Accepting new patients
Highlands Anesthesia LLC Anesthesiology Past Accepting new patients

Locations

3995 NW Goldenrod Rd
Jensen Beach, FL 34957
Phone (772) 497-0020

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

10080 SW Innovation Way
Ste 101
Port St Lucie, FL 34987
Phone (561) 358-2445

3602 Kyoto Gardens Dr
West Palm Beach, FL 33410
Phone (561) 799-2288

134 Homer Ave
Cortland, NY 13045
Phone (607) 756-3500

2233 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-4141

Organizations & group practices 9

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1013961374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2381 SW RACQUET CLUB DR",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2381 SW RACQUET CLUB DR",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902608",
            "telephone_number": "772-418-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME61067",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2009-00912",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "14919",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377132600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm City, FL

Sources for this page

Verify at the official NPI Registry.