Individual provider Active NPI

Eric J Norenberg, MD

  • Family Medicine Physician
  • Ponte Vedra Beach, FL
National Provider Identifier
1316988173
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME56786 Issued in FL
Practice address
228 Ponte Vedra Park Dr Ste 500
Ponte Vedra Beach, FL 32082-6611
Phone
(904) 273-1180
Fax
(904) 273-6116
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME56786 FL Primary

Addresses

Primary practice location

228 Ponte Vedra Park Dr Ste 500
Ponte Vedra Beach, FL 32082-6611

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other identifiers 2

IdentifierTypeStateIssuer
09828OtherFLBCBS
KH840OtherFLMEDICARE

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
I20040916000909 FL Practitioner - Family Practice 0648247700 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME56786FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norenberg & Associates LLC Family Medicine Current Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Nov 1, 2018 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Nov 1, 2018 Accepting new patients
Family Care Partners Urgent Care, LLC Past Accepting new patients
Solantic LLC Past Accepting new patients
Baptist Primary Care Inc Family Medicine Past Accepting new patients
Baptist Primary Care Inc Family Medicine Past Accepting new patients

Locations

14540 Cortez Blvd
Ste 102
Brooksville, FL 34613
Phone (352) 596-7255

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

228 Ponte Vedra Park Dr
Ste 500
Ponte Vedra Beach, FL 32082
Phone (904) 273-1180

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1316988173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 PONTE VEDRA PARK DR STE 500",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320826611",
            "telephone_number": "904-273-1180",
            "fax_number": "904-273-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORENBERG",
        "first_name": "ERIC",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME56786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09828",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "KH840",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

Verify at the official NPI Registry.