Individual provider Active NPI

Eugene Vitaly Bednov, M.D.

  • Hospitalist Physician
  • Daytona Beach, FL
National Provider Identifier
1275988511
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME138698 Issued in FL
Practice address
303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone
(386) 425-1994
NPI assigned
Apr 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2019024536 MO
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X ME138698 FL Primary

Addresses

Primary practice location

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Mailing address

303 N Clyde Morris Blvd
10E PBFS
Daytona Beach, FL 32114-2709
Phone (386) 425-1994

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200826002938 FL Practitioner - Hospitalist 7416241716 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

1055 Saxon Blvd
Orange City, FL 32763-8468
Phone (386) 917-5000

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (386) 231-6000

Hospital & facility affiliations

  • Adventhealth Hospice Care East Florida Hospice, Ormond Beach, FL, CCN 101539
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019024536MOMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Healthcare Systems Inc Hospitalist CurrentSince Aug 17, 2020 Accepting new patients
Florida Hospital Healthcare Partners, Inc CurrentSince Nov 21, 2021 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

303 N Clyde Morris Blvd
#10E
Daytona Beach, FL 32114

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

3300 E Halifax Crossing Blvd
Deltona, FL 32725
Phone (386) 425-1800

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: ebednov64998@adventhealth.direct-ci.com

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 and National Provider Directory roles.

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": "1461456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1275988511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "address_2": "10E PBFS",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-425-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-425-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDNOV",
        "first_name": "EUGENE",
        "middle_name": "VITALY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-24",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2019024536",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME138698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.