NPIMap

Organization Active NPI

Neurology Associates of Ormond Beach PA

  • Specialist
  • Ormond Beach, FL
National Provider Identifier
1083679609
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NEUROLOGY ASSOCIATES OF ORMOND BEACH PA
Practice address
8 Mirror Lake Dr
Ste a
Ormond Beach, FL 32174-5935
Phone
(386) 673-2500
Fax
(386) 673-3204
NPI assigned
Apr 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Authorized official

Name
Ms. Devon Buono
Title
Office Manager
Phone
(386) 673-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

8 Mirror Lake Dr
Ste a
Ormond Beach, FL 32174-5935

Mailing address

8 Mirror Lake Dr
Ste a
Ormond Beach, FL 32174-5935
Phone (386) 673-2500

Other identifiers 3

IdentifierTypeStateIssuer
250638600MedicaidFL
40662OtherFLBLUE CROSS
CC7418OtherFLRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040612000013 FL Part B Supplier - Clinic/Group Practice 1355324047 Receives reassigned benefits from 22 practitioners
Practice locations: Ormond Beach, FL

National Provider Directory

National Provider Directory

Locations

301 N Clyde Morris Blvd
Daytona Beach, FL 32114

8 Mirror Lake Dr
Ste A
Ormond Beach, FL 32174
Phone (386) 673-2500

870 Dunlawton Ave
Ste 109
Port Orange, FL 32127
Phone (386) 427-3700

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1083679609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MIRROR LAKE DR",
            "address_2": "STE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745935",
            "telephone_number": "386-673-2500",
            "fax_number": "386-673-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MIRROR LAKE DR",
            "address_2": "STE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745935",
            "telephone_number": "386-673-2500",
            "fax_number": "386-673-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY ASSOCIATES OF ORMOND BEACH PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "BUONO",
        "authorized_official_first_name": "DEVON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "386-673-2500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250638600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "40662",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC7418",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.