Individual provider Active NPI

Elizabeth Ann Le, M.D.

  • Family Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1225232051
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
FL99663 Issued in FL
Practice address
350 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733
Phone
(386) 238-3221
Fax
(386) 238-3235
NPI assigned
Jun 14, 2007
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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 FL99663 FL Primary

Addresses

Primary practice location

350 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733

Mailing address

350 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733
Phone (386) 676-7130

Other identifiers 3

IdentifierTypeStateIssuer
55028OtherFLBCBS
1225232051OtherFLTRICARE
000237300MedicaidFL

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
I20090116000164 FL Practitioner - Family Practice 3577626597 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
FL99663FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Care Plan, Inc CurrentSince Aug 20, 2012 Accepting new patients
Florida Health Care Plan, Inc CurrentSince Aug 20, 2012 Accepting new patients

Locations

320 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 238-3200

320 N Clyde Morris Blvd
Ste D
Daytona Beach, FL 32114
Phone (386) 253-3255

350 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 238-3200

740 Dunlawton Ave
Ste 200
Port Orange, FL 32127
Phone (386) 763-1000

Interoperability endpoints

  • Direct secure messaging: elizabethle@fhcpfl.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1225232051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142733",
            "telephone_number": "386-676-7130",
            "fax_number": "862-383-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142733",
            "telephone_number": "386-238-3221",
            "fax_number": "386-238-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "FL99663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "55028",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1225232051",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000237300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.