Individual provider Active NPI

Edward Bevier Spellerberg, MD

  • Anesthesiology Physician
  • Port Saint Lucie, FL
National Provider Identifier
1275735334
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME101813 Issued in FL
Practice address
1800 SE Tiffany Ave
Port Saint Lucie, FL 34952-7521
Phone
(772) 335-4000
NPI assigned
Jun 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME101813 FL Primary

Addresses

Primary practice location

1800 SE Tiffany Ave
Port Saint Lucie, FL 34952-7521

Mailing address

1800 SE Tiffany Ave
Port Saint Lucie, FL 34952-7521
Phone (772) 335-4000

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
I20080721000560 FL Practitioner - Anesthesiology 7810060050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Cincinnati College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1800 SE Tiffany Ave
Port Saint Lucie, FL 34952-7521
Phone (954) 939-5000

5301 S Congress Ave
Atlantis, FL 33462-1149
Phone (954) 939-5000

7201 N University Dr
Tamarac, FL 33321-2913
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Physician Solutions of South Florida, LLC Anesthesiology Current Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Anesthesiology CurrentSince May 3, 2015 Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Anesthesiology CurrentSince May 3, 2015 Accepting new patients
Atlantic Coast Anesthesia Associates Anesthesiology Past Accepting new patients

Locations

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1275735334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 SE TIFFANY AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527521",
            "telephone_number": "772-335-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SE TIFFANY AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527521",
            "telephone_number": "772-335-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLERBERG",
        "first_name": "EDWARD",
        "middle_name": "BEVIER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME101813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.