Individual provider Active NPI

William Kirby Edge, PA

  • Physician Assistant
  • West Palm Beach, FL
National Provider Identifier
1619945144
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103029 Issued in FL
Practice address
1309 N Flagler Dr
West Palm Beach, FL 33401-3406
Phone
(561) 655-5511
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9103029 FL Primary

Addresses

Primary practice location

1309 N Flagler Dr
West Palm Beach, FL 33401-3406

Mailing address

12888 Meadow Breeze Dr
Wellington, FL 33414-2014
Phone (561) 389-5907

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050929000499 FL Practitioner - Physician Assistant 7416982343 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9103029FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Emergency Services of Florida PA Physician Assistant CurrentSince Aug 15, 2022 Accepting new patients
Sterling Emergency Services of Florida PA Physician Assistant CurrentSince Aug 15, 2022 Accepting new patients

Locations

2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

1309 N Flagler Dr
West Palm Beach, FL 33401
Phone (561) 650-6309

Organizations & group practices 7

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1619945144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12888 MEADOW BREEZE DR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334142014",
            "telephone_number": "561-389-5907",
            "fax_number": "561-333-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 N FLAGLER DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013406",
            "telephone_number": "561-655-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGE",
        "first_name": "WILLIAM",
        "middle_name": "KIRBY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.