Individual provider Active NPI

Erich Glenn C Acebedo, MD

  • Internal Medicine Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1609019918
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14302 Issued in NV
Practice address
11380 Prosperity Farms Rd Ste 104
Palm Beach Gardens, FL 33410-3450
Phone
(561) 283-1166
Fax
(561) 910-4645
NPI assigned
Apr 16, 2009
Last updated
Sep 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C161085 CA
Internal Medicine Physician 207R00000X 036122547 IL
Internal Medicine Physician 207R00000X 14302 NV Primary

Addresses

Primary practice location

11380 Prosperity Farms Rd Ste 104
Palm Beach Gardens, FL 33410-3450

Mailing address

11380 Prosperity Farms Rd Ste 104
Palm Beach Gardens, FL 33410-3450
Phone (561) 283-1166

Other identifiers 1

IdentifierTypeStateIssuer
14302OtherNVNV LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Aug 2, 2021 through Aug 2, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14302NVMDPharmacist
C161085CAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: eacebedo@yourcarecommunity.org

NPI Registry JSON

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1609019918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11380 PROSPERITY FARMS RD STE 104",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103450",
            "telephone_number": "561-283-1166",
            "fax_number": "561-910-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11380 PROSPERITY FARMS RD STE 104",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103450",
            "telephone_number": "561-283-1166",
            "fax_number": "561-910-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEBEDO",
        "first_name": "ERICH GLENN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-16",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C161085",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036122547",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "14302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV LICENSE",
            "identifier": "14302",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.