Individual provider Active NPI

Johann L Santa Eulalia, MD

  • Anesthesiology Physician
  • Stuart, FL
National Provider Identifier
1295918464
Registry record updated Oct 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME100397 Issued in FL
Practice address
421 SE Osceola St
Suite 3
Stuart, FL 34994-2505
Phone
(772) 286-0338
Fax
(772) 287-1139
NPI assigned
Dec 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD432980 PA
Anesthesiology Physician 207L00000X ME100397 FL Primary

Addresses

Primary practice location

421 SE Osceola St
Suite 3
Stuart, FL 34994-2505

Mailing address

421 SE Osceola St
Ste 3
Stuart, FL 34994-2505
Phone (772) 286-0338

Other identifiers 1

IdentifierTypeStateIssuer
52185OtherFLBCBS FL

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
I20081008000024 FL Practitioner - AnesthesiologyPractitioner - Pain Management 7315023280 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD432980PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Lucie Anesthesia Associates, LLC Anesthesiology CurrentSince Jan 3, 2024 Accepting new patients
Bethesda Anesthesia Associates, Inc. Anesthesiology Current Accepting new patients
St. Lucie Anesthesia Associates, LLC Anesthesiology CurrentSince Jan 3, 2024 Accepting new patients
East Coast Anesthesia LLC Anesthesiology CurrentSince Mar 12, 2024 Accepting new patients
St Lucie Anesthesia Associates LLC Anesthesiology Current Accepting new patients
Anesthesiology Professional Services, Inc. Anesthesiology CurrentSince Jan 31, 2024 Accepting new patients
Treasure Coast Anesthesia Group PA Anesthesiology CurrentSince Jun 1, 2013 Accepting new patients

Locations

2234 N Federal Hwy
Boca Raton, FL 33431
Phone (561) 306-5469

10301 Hagen Ranch Rd
Ste 520
Boynton Beach, FL 33437
Phone (561) 374-5550

401 SW 42nd Ave
Ste 201
Coral Gables, FL 33134
Phone (305) 447-0882

3995 NW Goldenrod Rd
Jensen Beach, FL 34957
Phone (772) 497-0020

460 Saint Charles Ct
Lake Mary, FL 32746
Phone (407) 585-0260

10000 SW Innovation Way
Port St Lucie, FL 34987
Phone (772) 288-5853

10080 SW Innovation Way
Ste 101
Port St Lucie, FL 34987
Phone (561) 358-2445

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

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

509 SE Riverside Dr
Stuart, FL 34994
Phone (772) 223-2300

2100 SE Salerno Rd
Stuart, FL 34997
Phone (772) 223-2300

1155 SE Monterey Road Ext
Stuart, FL 34994
Phone (772) 286-8028

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223596800000",
    "number": "1295918464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SE OSCEOLA ST",
            "address_2": "STE 3",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942505",
            "telephone_number": "772-286-0338",
            "fax_number": "772-287-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 SE OSCEOLA ST",
            "address_2": "SUITE 3",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942505",
            "telephone_number": "772-286-0338",
            "fax_number": "772-287-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTA EULALIA",
        "first_name": "JOHANN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-11",
        "last_updated": "2008-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD432980",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME100397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "52185",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.