Eric Lee Ceithaml, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

ME50651 Issued in FL

Practice address

836 Prudential Dr Ste 802
Jacksonville, FL 32207-8335

Phone

(904) 202-8290

Fax

(904) 202-8171

NPI assigned

Feb 7, 2006

Last updated

Oct 2, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: eceithaml734505@direct.hopkinsmedicine.org

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.

• Baptist Specialty Physicians Inc

  dba Wolfson Children's Specialty Services

  • Pediatric Cardiology Physician
  • Jacksonville, FL
  • NPI 1184392847
  NPD (past)
• Baptist Specialty Physicians Inc

  dba Wolfson Children's Specialty Services

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Jacksonville, FL
  • NPI 1285149138
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1063485506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44047",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314047",
            "telephone_number": "904-376-4083",
            "fax_number": "904-391-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 802",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078335",
            "telephone_number": "904-202-8290",
            "fax_number": "904-202-8171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Prudential Dr",
            "address_2": "Suite 202 / UFJP Wolfson's",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "32207",
            "country_code": "US",
            "telephone_number": "904-202-8290",
            "fax_number": "904-202-8171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEITHAML",
        "first_name": "ERIC",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME50651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000367617A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0457868-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.