Organization Active NPI

Arthur J Debaise MD PA

  • Specialist
  • Winter Park, FL
National Provider Identifier
1104067032
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0057231 Issued in FL
Legal business name
ARTHUR J DEBAISE MD PA
Practice address
320 Edinburgh Dr
Suite a
Winter Park, FL 32792-4157
Phone
(407) 539-3455
Fax
(407) 539-3481
NPI assigned
Mar 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2009

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

Authorized official

Name
Dr. Arthur J Debaise, M DNPI 1235276056
Title
Owner
Phone
(407) 539-3455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME0057231 FL Primary

Addresses

Primary practice location

320 Edinburgh Dr
Suite a
Winter Park, FL 32792-4157

Mailing address

320 Edinburgh Drive
Suite a
Winter Park, FL 32792
Phone (407) 539-3455

Other identifiers 1

IdentifierTypeStateIssuer
379448200MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090610000473 FL Part B Supplier - Clinic/Group Practice 7719037951 Receives reassigned benefits from 1 practitioner
Practice locations: Winter Park, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242172800000",
    "number": "1104067032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 EDINBURGH DRIVE",
            "address_2": "SUITE A",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32792",
            "telephone_number": "407-539-3455",
            "fax_number": "407-539-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 EDINBURGH DR",
            "address_2": "SUITE A",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924157",
            "telephone_number": "407-539-3455",
            "fax_number": "407-539-3481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARTHUR J DEBAISE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-05-13",
        "status": "A",
        "authorized_official_last_name": "DEBAISE",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-539-3455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0057231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379448200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; 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.