Edward Allen Maybury, MD
Individual provider Active NPI Anesthesiology Physician · Jacksonville, FL
NPI 1366434128 · NPPES record last updated May 5, 2008
Key facts
- NPI
- 1366434128
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- ME 79595 (FL)
- Practice address
- 3625 University Blvd S
Jacksonville, FL 32216-4207 - Phone
- (904) 421-2119
- NPI assigned
- Aug 18, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Uniformed Services Uhs Fe Hebert School of Med, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Brevard Physician Associates PLLC
Practice addresses (Care Compare)
1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-7000
1425 Malabar Rd NE
Palm Bay, FL 32907-2506
Phone (321) 434-8000
701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3585
Phone (321) 799-7111
8731 N Wickham Rd
Melbourne, FL 32940-5997
Phone (321) 434-9000
8745 N Wickham Rd
Melbourne, FL 32940-5997
Phone (321) 434-9000
Hospital & facility affiliations
- Holmes Regional Medical Center
- Viera Hospital
- Cape Canaveral Hospital
- Palm Bay Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040730000450 | GA | Practitioner - Emergency Medicine | 4981674421 | Reassigns benefits to 1 organization |
| I20080422000433 | FL | Practitioner - Anesthesiology | 4981674421 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 79595 | FL | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nes Georgia, Inc. | Current |
Accepting new patients | |
| Brevard Physician Associates, PLLC | Anesthesiology | Current |
Accepting new patients |
| Nes Georgia Inc | Current |
Accepting new patients | |
| Nes Georgia, Inc. | Current | Accepting new patients | |
| Hospital Authority of Jeff Davis County Georgia | Past | Accepting new patients |
Locations
1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771
163 S Tallahassee St
Hazlehurst, GA 31539
Phone (912) 375-7781
Interoperability endpoints
- emaybury69528@epicdirect.hf.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | ME 79595 | FL | Yes |
Addresses
Primary practice location
3625 University Blvd S
Jacksonville, FL 32216-4207
Mailing address
PO Box 440219
Jacksonville, FL 32222-0002
Other providers in Jacksonville, FL
- Lashandia King May
- Leah Abrea May
- Ryan I May
- Amaris Blanche Mayberry
- Christina Mayberry
- Hannah Mayderry
- Toni-Ann Hylton Mayembe
- David Joshua Mayer
- George L Mayer
- Jensen Mayer
All providers in Jacksonville, FL · Anesthesiology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.