NPIMap

Individual provider Active NPI

Eleanor Grant Price, D.O.

  • Family Medicine Physician
  • Miramar, FL
National Provider Identifier
1053666354
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS16985 Issued in FL
Practice address
10910 Pembroke Rd
Miramar, FL 33025-1706
Phone
(954) 276-5552
Fax
(954) 443-4737
NPI assigned
Jul 23, 2012
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS16985 FL Primary

Addresses

Primary practice location

10910 Pembroke Rd
Miramar, FL 33025-1706

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-5710
Phone (954) 276-5603

Other identifiers 1

IdentifierTypeStateIssuer
112163200MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eprice362818@MHSDIRECT.NET Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210928000703 FL Practitioner - Family Practice 4688987191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

10910 Pembroke Rd
Miramar, FL 33025-1706
Phone (954) 265-8100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Jan 29, 2024 Accepting new patients
South Broward Hospital District CurrentSince Jan 29, 2024 Accepting new patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

10910 Pembroke Rd
Miramar, FL 33025
Phone (954) 265-8100

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Interoperability endpoints

  • Direct secure messaging: eprice362818@mhsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1053666354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330255710",
            "telephone_number": "954-276-5603",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10910 PEMBROKE RD",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330251706",
            "telephone_number": "954-276-5552",
            "fax_number": "954-443-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "ELEANOR",
        "middle_name": "GRANT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS16985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112163200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eprice362818@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10910 Pembroke Rd",
            "city": "Miramar",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330251706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.