Active NPI
Steven D Eggen, M.D.
- Pediatrics Physician
- Palm Bay, FL
National Provider Identifier
1417928052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME42301
- Practice address
- 5055 Babcock St NE
Palm Bay, FL 32905-4673 - Phone
- (321) 724-1200
- Fax
- (321) 951-0675
- NPI assigned
- Jan 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME42301 | FL | Primary |
Addresses
Primary practice location
5055 Babcock St NE
Palm Bay, FL 32905-4673
Mailing address
5055 Babcock St NE
Palm Bay, FL 32905-4673
Phone (321) 724-1200
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1116 | Other | FL | HEALTH FIRST |
| 1200628 | Other | FL | UNITED |
| 20693 | Other | FL | AETNA HMO |
| 4039001 | Other | FL | AETNA |
| 28758 | Other | FL | WELLCARE |
| 79800 | Other | FL | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME42301 | FL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417928052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5055 BABCOCK ST NE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329054673",
"telephone_number": "321-724-1200",
"fax_number": "321-951-0675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5055 BABCOCK ST NE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329054673",
"telephone_number": "321-724-1200",
"fax_number": "321-951-0675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGGEN",
"first_name": "STEVEN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME42301",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH FIRST",
"identifier": "1116",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED",
"identifier": "1200628",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "20693",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4039001",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "28758",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "79800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.