Princeton Pediatrics, PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PRINCETON PEDIATRICS, PA

Doing business as

Edgewater Pediatrics

Practice address

4804 Edgewater Dr Ste B
Orlando, FL 32804-1126

Phone

(407) 290-3344

Fax

(877) 767-4236

NPI assigned

Jan 18, 2012

Last updated

Jul 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ted Adam Kaplan, MDNPI 1316984909

Title

Physician

Phone

(407) 290-3344

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Edgewater Pediatrics Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ted Adam Kaplan, M.D.

  • Pediatrics Physician
  • Orlando, FL
  • NPI 1316984909
  NPD Authorized official
• Esther Luc Pelissier, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Orlando, FL
  • NPI 1477978781

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1497026793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4804 EDGEWATER DR STE B",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328041126",
            "telephone_number": "407-290-3344",
            "fax_number": "877-767-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4804 EDGEWATER DR STE B",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328041126",
            "telephone_number": "407-290-3344",
            "fax_number": "877-767-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON PEDIATRICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "KAPLAN",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "407-290-3344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "804240",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123233500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgewater Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David James Prince, LCSW
• Kayla Prince
• Kristen Prince, PHARMD
• Lourdes Elena Prince, ARNP
• Thomas Roy Prince, M.D.
• Princeton Professional Services (Florida Hospital Home Care Services)
• Principal Pediatric Group LLC
• Jonathan Raymond Printup
• Heather Priore
• Priority Home Health Care Services LLC

• Pediatrics Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.