Individual provider Active NPI

Edward W Pearson, M.D. , ABIHM

  • General Practice Physician
  • N Palm Beach, FL
National Provider Identifier
1306913876
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME83846 Issued in FL
Practice address
1201 US Highway 1
Suite 46
N Palm Beach, FL 33408-3550
Phone
(561) 290-4325
Fax
(561) 629-7291
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME83846 FL Primary

Addresses

Primary practice location

1201 US Highway 1
Suite 46
N Palm Beach, FL 33408-3550

Mailing address

1201 US Highway 1
Suite 46
N Palm Beach, FL 33408-3550
Phone (561) 290-4325

Other identifiers 2

IdentifierTypeStateIssuer
11012OtherFLBCBS
2657406-00MedicaidFL

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
I20081118000489 FL Practitioner - Internal MedicinePractitioner - General PracticePractitioner - Physical Medicine and Rehabilitation 6901822014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Florida College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Medical and Wellness Center, PLLCGroup PAC ID 1254470487, 3 clinicians

Practice addresses (Care Compare)

1818 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5545
Phone (772) 353-5370

3257 SE Salerno Rd
Unit 3
Stuart, FL 34997-6740
Phone (772) 286-5277

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical & Wellness Center, PLLC CurrentSince Mar 16, 2015 Accepting new patients
Union Medical Center LLC General Practice CurrentSince Nov 1, 2023 Accepting new patients
Pearson Wellness Center General Practice Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Retinovitreous Associates LTD PastSince Mar 16, 2015 Accepting new patients

Locations

1818 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (772) 353-5370

3257 SE Salerno Rd
Unit 3
Stuart, FL 34997
Phone (772) 286-5277

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: edward.pearson.1@30886.direct.athenahealth.com

Organizations & group practices 5

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306913876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 US HIGHWAY 1",
            "address_2": "SUITE 46",
            "city": "N PALM BEACH",
            "state": "FL",
            "postal_code": "334083550",
            "telephone_number": "561-290-4325",
            "fax_number": "561-629-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 US HIGHWAY 1",
            "address_2": "SUITE 46",
            "city": "N PALM BEACH",
            "state": "FL",
            "postal_code": "334083550",
            "telephone_number": "561-290-4325",
            "fax_number": "561-629-7291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "EDWARD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D. , ABIHM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME83846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "11012",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2657406-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in N Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.