Individual provider Active NPI

Nathan E Bach, DO

  • Emergency Medicine Physician
  • Ormond Beach, FL
National Provider Identifier
1508284381
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
14627 Issued in FL
Practice address
298 S Yonge St
Ormond Beach, FL 32174-6264
Phone
(386) 274-7800
NPI assigned
Mar 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 14276 FL
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 14627 FL Primary

Addresses

Primary practice location

298 S Yonge St
Ormond Beach, FL 32174-6264

Mailing address

298 S Yonge St
Ormond Beach, FL 32174-6264
Phone (386) 274-7800

Other practice location 1

655 W 8th St
Jacksonville, FL 32209-6511
Phone (904) 244-5848

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
I20170526000468 FL Practitioner - Emergency Medicine 0648498261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Professionals PAGroup PAC ID 0446244362, 20 clinicians

Practice addresses (Care Compare)

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (386) 231-6000

Hospital & facility affiliations

  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14276FLMDEmergency Medicine Physician
14627FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Professionals PA Emergency Medicine CurrentSince May 1, 2017 Accepting new patients

Locations

301 Memorial Medical Pkwy
Holly Hill, FL 32117
Phone (386) 231-3906

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

Organizations & group practices 1

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 2

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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1508284381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 S YONGE ST",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746264",
            "telephone_number": "386-274-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 S YONGE ST",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746264",
            "telephone_number": "386-274-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-244-5848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACH",
        "first_name": "NATHAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "14276",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "14627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.