Individual provider Active NPI

Dina Alaa Elbanna, DO

  • Emergency Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1154946473
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS20426 Issued in FL
Practice address
222 S Peninsula Dr
Daytona Beach, FL 32118-4422
Phone
(386) 310-2160
Fax
(386) 310-2106
NPI assigned
Jun 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5151014570 MI
Emergency Medicine Physician 207P00000X OS20426 FL Primary

Addresses

Primary practice location

222 S Peninsula Dr
Daytona Beach, FL 32118-4422

Mailing address

222 S Peninsula Dr
Daytona Beach, FL 32118-4422
Phone (386) 310-2160

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
I20231023001182 FL Practitioner - Emergency Medicine 9133541667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Professionals PA Emergency Medicine CurrentSince Oct 12, 2023 Accepting new patients

Locations

222 S Peninsula Dr
Daytona Beach, FL 32118
Phone (386) 310-2160

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1154946473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S PENINSULA DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321184422",
            "telephone_number": "386-310-2160",
            "fax_number": "386-310-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S PENINSULA DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321184422",
            "telephone_number": "386-310-2160",
            "fax_number": "386-310-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELBANNA",
        "first_name": "DINA",
        "middle_name": "ALAA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5151014570",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS20426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.