Individual provider Active NPI

Ted Marshall Feldman, PA-C

  • Physician Assistant
  • Port Saint Lucie, FL
National Provider Identifier
1407945256
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA113062 Issued in FL
Practice address
9401 SW Discovery Way Ste 101
Port Saint Lucie, FL 34987-2381
Phone
(772) 288-2400
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA113062 FL
Surgical Physician Assistant 363AS0400X MA002553-L PA
Physician Assistant 363A00000X PA113062 FL Primary

Addresses

Primary practice location

9401 SW Discovery Way Ste 101
Port Saint Lucie, FL 34987-2381

Mailing address

1050 SE Monterey Rd Ste 400
Stuart, FL 34994-4512
Phone (772) 288-2400

Other practice location 1

716 W Germantown Pike
East Norriton, PA 19403-4255
Phone (610) 630-4414 ext. 207

Other practice location 2

1050 SE Monterey Rd Ste 400
Stuart, FL 34994-4512
Phone (772) 288-2400

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200810001034 FL Practitioner - Physician Assistant 9830326693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Florida Orthopaedics and Sports Medicine, PAGroup PAC ID 6406838895, 70 clinicians

Practice addresses (Care Compare)

1050 SE Monterey Rd
Stuart, FL 34994-4512

Hospital & facility affiliations

  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA113062FLMDSurgical Physician Assistant
MA002553-LPAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Orthopaedics & Sports Medicine, PA CurrentSince Aug 1, 2020 Accepting new patients
South Florida Orthopaedics & Sports Medicine, PA CurrentSince Aug 1, 2020 Accepting new patients
South Florida Orthopaedics & Sports Medicine,PA Past Accepting new patients

Locations

9401 SW Discovery Way
Ste 101
Port St Lucie, FL 34987
Phone (772) 261-6824

1050 SE Monterey Rd
Ste 204
Stuart, FL 34994
Phone (772) 781-5960

1050 SE Monterey Rd
Ste 400
Stuart, FL 34994

Interoperability endpoints

  • Direct secure messaging: ted.feldmanpa.p1@direct.southflaortho.nextgenshare.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 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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1407945256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SE MONTEREY RD STE 400",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-288-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SW DISCOVERY WAY STE 101",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872381",
            "telephone_number": "772-288-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "716 W Germantown Pike",
            "address_purpose": "LOCATION",
            "city": "East Norriton",
            "state": "PA",
            "postal_code": "194034255",
            "country_code": "US",
            "telephone_number": "610-630-4414 x207",
            "fax_number": "610-630-8818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 SE Monterey Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349944512",
            "country_code": "US",
            "telephone_number": "772-288-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELDMAN",
        "first_name": "TED",
        "middle_name": "MARSHALL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA113062",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA002553-L",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA113062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.