Individual provider Active NPI

Donna Louise Bacon, M.D.

  • Family Medicine Physician
  • Rockledge, FL
National Provider Identifier
1215934476
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME71719 Issued in FL
Practice address
1282 US Highway 1 Ste 1
Rockledge, FL 32955-2747
Phone
(321) 631-3693
Fax
(321) 631-7618
NPI assigned
Jul 2, 2005
Last updated
Jun 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME71719 FL Primary

Addresses

Primary practice location

1282 US Highway 1 Ste 1
Rockledge, FL 32955-2747

Mailing address

1282 US Highway 1 Ste 1
Rockledge, FL 32955-2747
Phone (321) 631-3693

Other identifiers 1

IdentifierTypeStateIssuer
101544100MedicaidFL

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
I20090715000650 FL Practitioner - Family Practice 1557413937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1282 US Hwy 1
Suite 1
Rockledge, FL 32955-2747
Phone (321) 631-3693

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Donna L Bacon MD PA Family Medicine CurrentSince Apr 8, 2009 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

7227 N US Highway 1
Port St John, FL 32927
Phone (321) 631-3693

1282 US Highway 1
Ste 1
Rockledge, FL 32955
Phone (321) 631-3693

Interoperability endpoints

  • Direct secure messaging: donna.bacon.1@11488.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11488/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1120262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1215934476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1282 US HIGHWAY 1 STE 1",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552747",
            "telephone_number": "321-631-3693",
            "fax_number": "844-772-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1282 US HIGHWAY 1 STE 1",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552747",
            "telephone_number": "321-631-3693",
            "fax_number": "321-631-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "DONNA",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-02",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME71719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101544100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

Verify at the official NPI Registry.