NPIMap

Individual provider Active NPI

Michael Bernard Harris, M.D.

  • Family Medicine Physician
  • Panama City Beach, FL
National Provider Identifier
1396849691
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME110323 Issued in FL
Practice address
12234 Panama City Beach Pkwy Ste B
Panama City Beach, FL 32407-2726
Phone
(850) 233-2323
Fax
(850) 233-1055
NPI assigned
Sep 8, 2006
Last updated
Aug 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X ME110323 FL
Family Medicine Physician 207Q00000X ME110323 FL Primary

Addresses

Primary practice location

12234 Panama City Beach Pkwy Ste B
Panama City Beach, FL 32407-2726

Mailing address

12234 Panama City Beach Pkwy Ste B
Panama City Beach, FL 32407-2726
Phone (850) 233-2323

Other identifiers 2

IdentifierTypeStateIssuer
58926OtherFLFLORIDA BLUE (BCBSFL)
004001500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110912000634 FL Practitioner - Family PracticePractitioner - Sports Medicine 0042202111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians

Practice addresses (Care Compare)

12234 Panama City Beach Pkwy
Panama City, FL 32407-2725
Phone (770) 312-5226

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.79 of 100Reported as apm
Quality
86.5
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME110323FLMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Florida, LLC CurrentSince Jan 1, 2025 Accepting new patients
Kootenai Health, Inc. Past Accepting new patients
Bayfront Enterprises Inc Past Accepting new patients

Locations

140 6th Ave
Indialantic, FL 32903
Phone (321) 312-3501

13163 66th St
Largo, FL 33773
Phone (813) 344-3627

12234 Panama City Beach Pkwy
Ste B
Panama City Beach, FL 32407
Phone (850) 233-2301

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958
Phone (727) 617-1777

Interoperability endpoints

  • Direct secure messaging: michael.harris.1@8042.direct.athenahealth.com

Organizations & group practices 4

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 7

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": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1396849691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12234 PANAMA CITY BEACH PKWY STE B",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072726",
            "telephone_number": "850-233-2323",
            "fax_number": "850-233-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12234 PANAMA CITY BEACH PKWY STE B",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072726",
            "telephone_number": "850-233-2323",
            "fax_number": "850-233-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MICHAEL",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME110323",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME110323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE (BCBSFL)",
            "identifier": "58926",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004001500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City Beach, FL

Sources for this page

Verify at the official NPI Registry.