Individual provider Active NPI

Anthony Tucker, MD

  • Emergency Medicine Physician
  • Palm Bay, FL
National Provider Identifier
1356421366
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME120268 Issued in FL
Practice address
1840 Eldron Blvd SE Ste 1
Palm Bay, FL 32909-6871
Phone
(321) 312-4580
Fax
(321) 914-4053
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 171620 NY
Emergency Medicine Physician 207P00000X ME120268 FL Primary

Addresses

Primary practice location

1840 Eldron Blvd SE Ste 1
Palm Bay, FL 32909-6871

Mailing address

1840 Eldron Blvd SE Ste 1
Palm Bay, FL 32909-6871
Phone (321) 312-4580

Other practice location 1

427 Guy Park Ave
Amsterdam, NY 12010-1054
Phone (518) 842-7241

Other identifiers 1

IdentifierTypeStateIssuer
02585871MedicaidNY

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
I20140806001934 FL Practitioner - Emergency Medicine 4880656040 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME120268FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Solantic of Jacksonville, LLC Emergency Medicine CurrentSince Feb 10, 2015 Accepting new patients
Solantic/South Florida, LLC CurrentSince Feb 10, 2015 Accepting new patients
Restore Health Management LLC CurrentSince Feb 1, 2016 Accepting new patients
Shands/Solantic Joint Venture, LLC CurrentSince Feb 10, 2015 Accepting new patients
Hma/Solantic Joint Venture, LLC CurrentSince Feb 10, 2015 Accepting new patients
Missouri Em-I Medical Services, P.C. Emergency Medicine Past Accepting new patients
Adirondack Emergency Medicine, PC Emergency Medicine Past Accepting new patients
Dwic of Tampa Bay, Inc Past Accepting new patients
Utica Emergency Physicians, PC Emergency Medicine Past Accepting new patients
Little Blue Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Hannibal Regional Healthcare System Inc Past Accepting new patients

Locations

720 SW 2nd Ave
Ste 160A
Gainesville, FL 32601
Phone (352) 240-8000

2401 Monument Rd
Jacksonville, FL 32225
Phone (904) 642-0337

1840 Eldron Blvd SE
Ste 1
Palm Bay, FL 32909
Phone (321) 312-4580

9035 Pines Blvd
Pembroke Pines, FL 33024
Phone (954) 340-5881

1820 58th Ave
Ste 110
Vero Beach, FL 32966
Phone (772) 257-3200

463941 State Road 200
Yulee, FL 32097
Phone (904) 572-1959

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602

Organizations & group practices 11

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1356421366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 ELDRON BLVD SE STE 1",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329096871",
            "telephone_number": "321-312-4580",
            "fax_number": "321-914-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 ELDRON BLVD SE STE 1",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329096871",
            "telephone_number": "321-312-4580",
            "fax_number": "321-914-4053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "427 Guy Park Ave",
            "address_purpose": "LOCATION",
            "city": "Amsterdam",
            "state": "NY",
            "postal_code": "120101054",
            "country_code": "US",
            "telephone_number": "518-842-7241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "171620",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME120268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02585871",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.