Individual provider Active NPI

David Teitelbaum, MD

  • Obstetrics & Gynecology Physician
  • Pace, FL
National Provider Identifier
1619962909
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME 42346 Issued in FL
Practice address
3032 Killarney Dr Ste 3
Pace, FL 32571-8430
Phone
(407) 468-3102
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME 42346 FL Primary

Addresses

Primary practice location

3032 Killarney Dr Ste 3
Pace, FL 32571-8430

Mailing address

3032 Killarney Dr Ste 3
Pace, FL 32571-8430
Phone (407) 468-3102

Other identifiers 1

IdentifierTypeStateIssuer
271382900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL, CA, AZ4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20050413000126 FL Practitioner - Obstetrics/Gynecology 1153368998 Reassigns benefits to 1 organization
I20160315001398 AL Practitioner - Obstetrics/GynecologyPractitioner - Internal Medicine 1153368998 Reassigns benefits to 1 organization
I20170210000356 CA Practitioner - Obstetrics/Gynecology 1153368998 Reassigns benefits to 1 organization
I20220322002252 AZ Practitioner - Obstetrics/Gynecology 1153368998 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 42346FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra ER Department Physicians Medical Group Inc. CurrentSince Jan 4, 2017 Accepting new patients
Kingman Healthcare, Inc Family Medicine Current Accepting new patients
City of Jackson Healthcare Authority CurrentSince Mar 11, 2018 Accepting new patients
Kingman Healthcare, Inc CurrentSince Feb 1, 2022 Accepting new patients
Kingman Healthcare, Inc CurrentSince Feb 1, 2022 Accepting new patients
Kingman Healthcare, Inc Family Medicine Past Accepting new patients
Central Florida Family Health Center, Inc. Past Accepting new patients
Hill Hospital of York Past Accepting new patients

Locations

220 Hospital Dr
Jackson, AL 36545
Phone (251) 246-1159

1739 E Beverly Ave
Ste 200
Kingman, AZ 86409
Phone (928) 263-4722

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

1800 Spring Ridge Dr
Susanville, CA 96130
Phone (530) 252-2225

Interoperability endpoints

  • Direct secure messaging: david.teitelbaum.1@3681.direct.athenahealth.com

Organizations & group practices 9

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1619962909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3032 KILLARNEY DR STE 3",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325718430",
            "telephone_number": "407-468-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3032 KILLARNEY DR STE 3",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325718430",
            "telephone_number": "407-468-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEITELBAUM",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME 42346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271382900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pace, FL

Sources for this page

Verify at the official NPI Registry.