Individual provider Active NPI

Paul Brian Thompson, M.D.

  • Surgery Physician
  • Cocoa, FL
National Provider Identifier
1629078423
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME48672 Issued in FL
Practice address
93 Delannoy Ave
Unit 1202
Cocoa, FL 32922
Phone
(321) 480-8315
Fax
(321) 433-1935
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME48672 FL Primary

Addresses

Primary practice location

93 Delannoy Ave
Unit 1202
Cocoa, FL 32922

Mailing address

93 Delannoy Ave
Unit 1202
Cocoa, FL 32922
Phone (321) 480-8315

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040412001747 FL Practitioner - General Surgery 2769476704 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME48672FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince May 1, 2017 Accepting new patients
Steward Medical Group, Inc. Surgery CurrentSince May 1, 2017 Accepting new patients
Stewart and Stewart a Medical Corporation Past Accepting new patients

Locations

255 N Sykes Creek Pkwy
Ste 101
Merritt Island, FL 32953
Phone (321) 338-7885

1133 Seminole Dr
Rockledge, FL 32955
Phone (321) 637-2975

8000 Ron Beatty Blvd
Ste A-3
Sebastian, FL 32976
Phone (772) 664-1388

Organizations & group practices 3

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1629078423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 DELANNOY AVE",
            "address_2": "UNIT 1202",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "32922",
            "telephone_number": "321-480-8315",
            "fax_number": "321-433-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 DELANNOY AVE",
            "address_2": "UNIT 1202",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "32922",
            "telephone_number": "321-480-8315",
            "fax_number": "321-433-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "PAUL",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME48672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

Verify at the official NPI Registry.