Individual provider Active NPI

Eric Duffy, D.O.

  • Surgery Physician
  • Port St Lucie, FL
National Provider Identifier
1376956045
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OS17089 Issued in FL
Practice address
1400 SE Goldtree Dr Ste 103
Port St Lucie, FL 34952-7582
Phone
(772) 335-8446
Fax
(772) 335-8499
NPI assigned
Jun 10, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X S1082 TX
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X OS17089 FL Primary

Addresses

Primary practice location

1400 SE Goldtree Dr Ste 103
Port St Lucie, FL 34952-7582

Mailing address

1400 SE Goldtree Dr Ste 103
Port St Lucie, FL 34952-7582
Phone (772) 335-8446

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
I20200909001679 FL Practitioner - General Surgery 9436497898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palm Beach General Surgery LLCGroup PAC ID 1456455021, 69 clinicians

Practice addresses (Care Compare)

1400 SE Goldtree Dr
Suite 102 104
Port St. Lucie, FL 34952-7582
Phone (772) 335-8446

Hospital & facility affiliations

  • St Lucie Medical Center Hospital, Port Saint Lucie, FL, CCN 100260

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)31
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS17089FLMDSurgery Physician
S1082TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Beach General Surgery LLC Surgery CurrentSince Sep 14, 2020 Accepting new patients
Palm Beach General Surgery LLC Surgery PastSince Aug 23, 2020 Accepting new patients

Locations

12953 Palms West Dr
Ste 201
Loxahatchee, FL 33470
Phone (561) 790-2111

1825 SE Tiffany Ave
Ste 101
Port St Lucie, FL 34952
Phone (772) 219-4026

1400 SE Goldtree Dr
Ste 102104
Port St Lucie, FL 34952
Phone (772) 398-7814

1881 SE Tiffany Ave
Ste 301
Port St Lucie, FL 34952

293 NW Peacock Blvd
Ste 204
Saint Lucie West, FL 34986
Phone (772) 879-4667

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: eric.duffy@hca4.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1376956045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SE GOLDTREE DR STE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527582",
            "telephone_number": "772-335-8446",
            "fax_number": "772-335-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SE GOLDTREE DR STE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527582",
            "telephone_number": "772-335-8446",
            "fax_number": "772-335-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-10",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "S1082",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS17089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.