Individual provider Active NPI

Christopher Michael Middendorf, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Pensacola, FL
National Provider Identifier
1154593259
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
OS12841 Issued in FL
Practice address
1549 Airport Blvd
Suite 430
Pensacola, FL 32504-8633
Phone
(850) 416-2686
Fax
(850) 416-2684
NPI assigned
Mar 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X OS12841 FL Primary

Addresses

Primary practice location

1549 Airport Blvd
Suite 430
Pensacola, FL 32504-8633

Mailing address

PO Box 2699
Pensacola, FL 32513-2699
Phone (850) 416-2686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160808000075 FL Practitioner - Anesthesiology 7214175140 Reassigns benefits to 1 organization
I20201203002667 AL Practitioner - Pain Management 7214175140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Nova Southeastern College of Osteo Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dynamic Pain and Wellness LLCGroup PAC ID 8527364058, 29 clinicians

Practice addresses (Care Compare)

1924 K Dauphin Island Pkwy
Mobile, AL 36605-3004
Phone (251) 308-9800

930 Mar Walt Dr
Fort Walton Beach, FL 32547-6706
Phone (850) 226-6801

Hospital & facility affiliations

  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093
  • North Okaloosa Medical Center Hospital, Crestview, FL, CCN 100122
  • HCA Florida West Hospital Hospital, Pensacola, FL, CCN 100231

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS12841FLMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Pain & Wellness LLC CurrentSince May 15, 2018 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Dynamic Pain & Wellness LLC Pain Medicine CurrentSince May 15, 2018 Accepting new patients
Dynamic Chiro & PT LLC Past Accepting new patients

Locations

2826 Ross Clark Cir
Ste 103
Dothan, AL 36301
Phone (251) 308-9800

1924K Dauphin Island Pkwy
Mobile, AL 36605
Phone (251) 308-9800

210 S Main St
Crestview, FL 32536
Phone (850) 306-3433

930 Mar Walt Dr
Unit C
Fort Walton Beach, FL 32547
Phone (850) 431-6183

930 Mar Walt Dr
Fort Walton Beach, FL 32547
Phone (850) 331-2930

6044 Doctors Park
Milton, FL 32570
Phone (786) 655-0529

5111 N 12th Ave
Unit B
Pensacola, FL 32504

5111 N 12th Ave
Pensacola, FL 32504
Phone (850) 291-7641

Interoperability endpoints

  • Direct secure messaging: christopher.middendorf@2498.securemail.prognocis.com

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 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": "1206662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1154593259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-416-2686",
            "fax_number": "850-416-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1549 AIRPORT BLVD",
            "address_2": "SUITE 430",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048633",
            "telephone_number": "850-416-2686",
            "fax_number": "850-416-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDENDORF",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-28",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "OS12841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.