Individual provider Active NPI

Steven Gregg Edelson, DC

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1578622262
Registry record updated Aug 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7207 Issued in FL
Practice address
4250 W Bay to Bay Blvd
Tampa, FL 33629-6608
Phone
(813) 831-8321
Fax
(813) 831-5143
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7207 FL Primary

Addresses

Primary practice location

4250 W Bay to Bay Blvd
Tampa, FL 33629-6608

Mailing address

4250 W Bay to Bay Blvd
Tampa, FL 33629-6608
Phone (813) 831-8321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050810000165 FL Practitioner - Chiropractic 2961431002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4250 Bay to Bay Blvd
Tampa, FL 33629-6608

4250 W Bay to Bay Blvd
Tampa, FL 33629-6608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH7207FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Edelson Wellness Center, LLC Chiropractor CurrentSince Jan 1, 1999 Accepting new patients

Locations

8780 Seminole Blvd
Seminole, FL 33772
Phone (727) 391-0221

4250 W Bay To Bay Blvd
Tampa, FL 33629
Phone (813) 831-8321

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.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1578622262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 W BAY TO BAY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336296608",
            "telephone_number": "813-831-8321",
            "fax_number": "813-831-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 W BAY TO BAY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336296608",
            "telephone_number": "813-831-8321",
            "fax_number": "813-831-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELSON",
        "first_name": "STEVEN",
        "middle_name": "GREGG",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.