Individual provider Active NPI

Eduardo F Safille, MD

  • Cardiovascular Disease Physician
  • Waycross, GA
National Provider Identifier
1376594622
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
080175 Issued in GA
Practice address
615 Pendleton St Ste B
Waycross, GA 31501
Phone
(912) 285-9994
Fax
(912) 285-9595
NPI assigned
May 12, 2006
Last updated
Jul 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 200600427 NC
Cardiovascular Disease Physician 207RC0000X 080175 GA Primary

Addresses

Primary practice location

615 Pendleton St Ste B
Waycross, GA 31501

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6401

Other names 1

  • Edward F Safille Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050405000355 FL Practitioner - Cardiovascular Disease (Cardiology) 2567436512 Reassigns benefits to 1 organization
I20181107001419 GA Practitioner - Cardiovascular Disease (Cardiology) 2567436512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Miami, LM Miller School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent's Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

1699 S 14TH St
Suite 9
Fernadina Beach, FL 32034-1964
Phone (904) 206-5000

615 Pendleton St
Waycross, GA 31501-4759
Phone (904) 285-9994

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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
080175GAMDCardiovascular Disease Physician
200600427NCMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc Cardiovascular Disease CurrentSince Aug 1, 2018 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Aug 1, 2018 Accepting new patients
Sentara Albemarle Regional Medical Center Past Accepting new patients

Locations

1699 S 14th St
Ste 9
Fernandina Beach, FL 32034
Phone (904) 206-5000

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

113 E 15th St
Alma, GA 31510
Phone (904) 602-4481

1506 Alice St
Waycross, GA 31501
Phone (912) 285-3086

615 Pendleton St
Waycross, GA 31501
Phone (912) 285-9994

615 Pendleton St
Ste B
Waycross, GA 31501
Phone (912) 285-9994

Interoperability endpoints

  • Direct secure messaging: eduardo.safille.1@8967.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1376594622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6401",
            "fax_number": "904-450-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 PENDLETON ST STE B",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "31501",
            "telephone_number": "912-285-9994",
            "fax_number": "912-285-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFILLE",
        "first_name": "EDUARDO",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "200600427",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "080175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDWARD",
            "last_name": "SAFILLE",
            "middle_name": "F",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.