Individual provider Active NPI

Edel Alvarez Galban, M.D.

  • General Practice Physician
  • Clearwater, FL
National Provider Identifier
1477930501
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN652 Issued in FL
Practice address
2878 Roosevelt Blvd
Clearwater, FL 33760-1923
Phone
(727) 474-3442
Fax
(727) 474-3648
NPI assigned
Apr 27, 2015
Last updated
Nov 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN652 FL Primary

Addresses

Primary practice location

2878 Roosevelt Blvd
Clearwater, FL 33760-1923

Mailing address

5512 18TH St NE
St Petersburg, FL 33703-1731
Phone (813) 453-7931

Other identifiers 1

IdentifierTypeStateIssuer
015831700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rebeccalaurenaprn@hushmail.com

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
I20160421000110 FL Practitioner - General Practice 8820396435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2878 Roosevelt Blvd
Clearwater, FL 33760-1923
Phone (813) 453-7931

5512 18TH St NE
Saint Petersburg, FL 33703-1731

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rebecca Lauren Aprn, LLC CurrentSince Jun 1, 2021 Accepting new patients
Edel Alvarez MD LLC CurrentSince Mar 31, 2021 Accepting new patients
Medical Home Doctors PastSince Nov 1, 2009 Accepting new patients

Locations

2878 Roosevelt Blvd
Clearwater, FL 33760
Phone (727) 507-8555

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1477930501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 18TH ST NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337031731",
            "telephone_number": "813-453-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2878 ROOSEVELT BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337601923",
            "telephone_number": "727-474-3442",
            "fax_number": "727-474-3648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ GALBAN",
        "first_name": "EDEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-27",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015831700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebeccalaurenaprn@hushmail.com",
            "affiliation": "N",
            "endpointDescription": "rebeccalaurenaprn@hushmail.com",
            "address_1": "2878 Roosevelt Blvd",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337601923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.