Individual provider Active NPI

Edward Henry George Becker III, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Lithia, FL
National Provider Identifier
1124162789
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
ME 116897 Issued in FL
Practice address
13837 Circa Crossing Dr
Lithia, FL 33547-4382
Phone
(813) 684-2663
Fax
(813) 685-6222
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X ME116897 FL
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X ME 116897 FL Primary

Addresses

Primary practice location

13837 Circa Crossing Dr
Lithia, FL 33547-4382

Mailing address

13837 Circa Crossing Dr
Lithia, FL 33547-4382
Phone (813) 684-2663

Other identifiers 1

IdentifierTypeStateIssuer
009249300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130910000461 FL Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 5092979351 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
University of Maryland School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Medical Group of Tampa Bay PAGroup PAC ID 9436220415, 34 clinicians

Practice addresses (Care Compare)

6901 Simmons Loop
Suite 201
Riverview, FL 33578-9498
Phone (813) 684-2663

Hospital & facility affiliations

  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
  • Adventhealth Riverview Hospital, Riverview, FL, CCN 100364

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 116897FLMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Development Partners LLC CurrentSince Feb 20, 2025 Accepting new patients

Locations

615 Vonderburg Dr
Brandon, FL 33511
Phone (813) 421-4663

13837 Circa Crossing Dr
Ste 100
Lithia, FL 33547
Phone (352) 256-2855

13837 Circa Crossing Dr
Lithia, FL 33547
Phone (813) 534-0102

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1124162789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13837 CIRCA CROSSING DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474382",
            "telephone_number": "813-684-2663",
            "fax_number": "813-685-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13837 CIRCA CROSSING DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474382",
            "telephone_number": "813-684-2663",
            "fax_number": "813-685-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "EDWARD",
        "middle_name": "HENRY GEORGE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME116897",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME 116897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009249300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithia, FL

Sources for this page

Verify at the official NPI Registry.