Active NPI
David Teitelbaum, MD
- Obstetrics & Gynecology Physician
- Pace, FL
National Provider Identifier
1619962909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- ME 42346
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 271382900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, AL, CA, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050413000126 | FL | Practitioner - Obstetrics/Gynecology | 1153368998 | Reassigns benefits to 1 organization |
| I20160315001398 | AL | Practitioner - Obstetrics/Gynecology | 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
| License | State | Type | Specialty |
|---|---|---|---|
| ME 42346 | FL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sierra ER Department Physicians Medical Group Inc. | Current | Accepting new patients | |
| Kingman Healthcare, Inc | Family Medicine | Current | Accepting new patients |
| City of Jackson Healthcare Authority | Current | Accepting new patients | |
| Kingman Healthcare, Inc | Current | Accepting new patients | |
| Kingman Healthcare, Inc | Current | 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
- 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.
-
- Emergency Medicine Physician
- Susanville, CA
- NPI 1033570247
CA
-
- Urgent Care Clinic/Center
- Kingman, AZ
- NPI 1760703805
-
- Community/Retail Pharmacy
- Kingman, AZ
- NPI 1992286298
-
- Federally Qualified Health Center (FQHC)
- Orlando, FL
- NPI 1649241704
-
- General Acute Care Hospital
- York, AL
- NPI 1891801718
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.