Individual provider Active NPI

William Steve Eubanks Jr., MD

  • Surgery Physician
  • Orlando, FL
National Provider Identifier
1164469748
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME0108617 Issued in FL
Practice address
2415 N. Orange Ave
Suite 400
Orlando, FL 32804
Phone
(407) 303-7399
Fax
(407) 303-7305
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2003031774 MO
Surgery Physician 208600000X ME0108617 FL Primary

Addresses

Primary practice location

2415 N. Orange Ave
Suite 400
Orlando, FL 32804

Mailing address

2415 N. Orange Ave
Suite 400
Orlando, FL 32804
Phone (407) 303-7399

Other identifiers 5

IdentifierTypeStateIssuer
185637OtherMOBLUE SHIELD/BLUE CHOICE
208795500MedicaidMO
630763OtherMOHEALTHLINK
003037600MedicaidFL
1701308OtherMOUNITED HEALTHCARE

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
I20110127001188 FL Practitioner - General Surgery 7810980554 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0108617FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Sep 8, 2013 Accepting new patients
Florida Hospital Medical Group Inc Surgery CurrentSince Sep 8, 2013 Accepting new patients
Adventist Health System Sunbelt Inc Surgery Past Accepting new patients
Curators of the University of Missouri Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2501 N Orange Ave
Ste 235
Orlando, FL 32804
Phone (407) 303-1967

2415 N Orange Ave
Ste 400
Orlando, FL 32804
Phone (407) 303-7203

7975 Lake Underhill Rd
Ste 200
Orlando, FL 32822
Phone (407) 303-5990

Organizations & group practices 5

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1164469748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 N. ORANGE AVE",
            "address_2": "SUITE 400",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32804",
            "telephone_number": "407-303-7399",
            "fax_number": "407-303-7305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 N. ORANGE AVE",
            "address_2": "SUITE 400",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32804",
            "telephone_number": "407-303-7399",
            "fax_number": "407-303-7305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "WILLIAM",
        "middle_name": "STEVE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2003031774",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME0108617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD/BLUE CHOICE",
            "identifier": "185637",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208795500",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "630763",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003037600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1701308",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.