Active NPI
Erich Glenn C Acebedo, MD
- Internal Medicine Physician
- Palm Beach Gardens, FL
National Provider Identifier
1609019918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 14302
- 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, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14302 | Other | NV | NV 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
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 14302 | NV | MD | Pharmacist |
| C161085 | CA | MD | Internal Medicine Physician |
Interoperability endpoints
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.