Individual provider Active NPI

Michael P Teepe, PA

  • Surgical Physician Assistant
  • Melbourne, FL
National Provider Identifier
1255877981
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9110026 Issued in FL
Practice address
2222 S. Harbor City Blvd
Suite 420
Melbourne, FL 32901
Phone
(321) 768-9914
Fax
(321) 953-1893
NPI assigned
Jan 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9102926 FL
Medical Physician Assistant 363AM0700X PA9110026 FL
Surgical Physician Assistant 363AS0400X PA9110026 FL Primary

Addresses

Primary practice location

2222 S. Harbor City Blvd
Suite 420
Melbourne, FL 32901

Mailing address

2222 S. Harbor City Blvd
Suite 420
Melbourne, FL 32901
Phone (321) 768-9914

Other identifiers 2

IdentifierTypeStateIssuer
120065100MedicaidFL
RW988OtherFLMEDICARE HF

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180626001418 FL Practitioner - Physician Assistant 6305191735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians
H2 Rehabilitation Services of Florida LLCGroup PAC ID 3971411851, shared by 10 NPIs, 257 clinicians

Practice addresses (Care Compare)

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-1401

2222 S Harbor City Blvd
Melbourne, FL 32901-5591
Phone (321) 723-7716

4270 Minton Rd
Suite 120
West Melbourne, FL 32904-9579
Phone (321) 984-2933

699 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3562

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9102926FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Medical Group, LLC CurrentSince Nov 27, 2023 Accepting new patients
Health First Medical Group, LLC CurrentSince Nov 27, 2023 Accepting new patients

Locations

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

2222 S Harbor City Blvd
Ste 420
Melbourne, FL 32901
Phone (321) 768-9914

1341 Medical Park Dr
Ste 201
Melbourne, FL 32901
Phone (321) 768-9914

Interoperability endpoints

  • Direct secure messaging: mteepe27135@epicdirect.hf.org

Organizations & group practices 3

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 5

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": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1255877981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S. HARBOR CITY BLVD",
            "address_2": "SUITE 420",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32901",
            "telephone_number": "321-768-9914",
            "fax_number": "321-953-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 S. HARBOR CITY BLVD",
            "address_2": "SUITE 420",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32901",
            "telephone_number": "321-768-9914",
            "fax_number": "321-953-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEEPE",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-19",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102926",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9110026",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9110026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120065100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HF",
            "identifier": "RW988",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.