NPIMap

Individual provider Active NPI

Larry Charles Deeb, M.D.

  • Pediatric Endocrinology Physician
  • Tallahassee, FL
National Provider Identifier
1497741839
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
ME 36405 Issued in FL
Practice address
2633 Centennial Blvd Ste 100
Tallahassee, FL 32308-0606
Phone
(850) 431-5404
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X ME 36405 FL Primary

Addresses

Primary practice location

2633 Centennial Blvd Ste 100
Tallahassee, FL 32308-0606

Mailing address

2633 Centennial Blvd
Suite 100
Tallahassee, FL 32309-0585
Phone (850) 877-7387

Other practice location 1

2804 Remington Green Cir
Suite 1
Tallahassee, FL 32308-8707
Phone (850) 878-0184

Other identifiers 3

IdentifierTypeStateIssuer
00241018CMedicaidGA
039439400MedicaidFL
37276OtherFLBLUECROSS BLUE SHIELD

Other names 1

  • Larry C. Deeb Other name

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
I20170524000364 FL Practitioner - Pediatric MedicinePractitioner - Endocrinology 5193092146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Endocrinology
Education
Emory University School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tallahassee Memorial Healthcare Inc 498 clinicians

Practice addresses (Care Compare)

2633 Centennial Blvd
Suite 100
Tallahassee, FL 32308-0606
Phone (850) 431-5404

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 36405FLMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Mar 15, 2017 Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Mar 15, 2017 Accepting new patients
Larry C. Deeb, M.D., P.a. Pediatric Endocrinology Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

15 Council Moore Rd
Crawfordville, FL 32327
Phone (850) 926-7105

1309 Thomasville Rd
Tallahassee, FL 32303
Phone (850) 431-5910

2633 Centennial Blvd
Tallahassee, FL 32308
Phone (850) 877-7387

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

2633 Centennial Blvd
Ste 100
Tallahassee, FL 32308
Phone (850) 431-5404

Interoperability endpoints

  • Direct secure messaging: ldeeb22230@tallahasseememorial.direct-ci.com
  • Direct secure messaging: larrydeeb@tmhpp.allscriptsdirect.net

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1497741839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 CENTENNIAL BLVD",
            "address_2": "SUITE 100",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323090585",
            "telephone_number": "850-877-7387",
            "fax_number": "850-656-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 CENTENNIAL BLVD STE 100",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080606",
            "telephone_number": "850-431-5404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2804 Remington Green Cir",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323088707",
            "country_code": "US",
            "telephone_number": "850-878-0184",
            "fax_number": "850-216-1537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEEB",
        "first_name": "LARRY",
        "middle_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "FL",
            "license": "ME 36405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00241018C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039439400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD",
            "identifier": "37276",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARRY",
            "last_name": "DEEB",
            "middle_name": "C.",
            "credential": "M.D.,P.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.