NPIMap

Organization Active NPI

Eric S Palosky, DO PA

  • Family Medicine Physician
  • Sebring, FL
National Provider Identifier
1376651554
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS0007466 Issued in FL
Legal business name
ERIC S PALOSKY, DO PA
Practice address
4343 Sun N Lake Blvd
Suite C
Sebring, FL 33872-2162
Phone
(863) 385-1777
Fax
(863) 385-8668
NPI assigned
Aug 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Authorized official

Name
Dr. Eric Scott Palosky, DONPI 1174718001
Title
President
Phone
(863) 385-1777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS0007466 FL Primary

Addresses

Primary practice location

4343 Sun N Lake Blvd
Suite C
Sebring, FL 33872-2162

Mailing address

4343 Sun N Lake Blvd
Suite C
Sebring, FL 33872-2162
Phone (863) 385-1777

Other identifiers 4

IdentifierTypeStateIssuer
10D1021161OtherFLCLIA - LAB
46263OtherFLBCBS OF FLORIDA
S0007466OtherFLFL MEDICAL LICENSE - W/C
026582690OtherFLTRICARE INDIVIDUAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000240 FL Part B Supplier - Clinic/Group Practice 6204720691 Receives reassigned benefits from 2 practitioners
Practice locations: Sebring, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285804800000",
    "number": "1376651554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 SUN N LAKE BLVD",
            "address_2": "SUITE C",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722162",
            "telephone_number": "863-385-1777",
            "fax_number": "863-385-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 SUN N LAKE BLVD",
            "address_2": "SUITE C",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722162",
            "telephone_number": "863-385-1777",
            "fax_number": "863-385-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC S PALOSKY, DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2010-09-30",
        "status": "A",
        "authorized_official_last_name": "PALOSKY",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-385-1777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0007466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA - LAB",
            "identifier": "10D1021161",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "46263",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICAL LICENSE - W/C",
            "identifier": "S0007466",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE INDIVIDUAL",
            "identifier": "026582690",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.