Individual provider Active NPI

Ed Tobenas, D.C.

  • Chiropractor
  • Longwood, FL
National Provider Identifier
1629122379
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 9040 Issued in FL
Practice address
1900 Boothe Cir
Suite 100
Longwood, FL 32750-6751
Phone
(407) 774-6800
Fax
(407) 774-6806
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 9040 FL Primary

Addresses

Primary practice location

1900 Boothe Cir
Suite 100
Longwood, FL 32750-6751

Mailing address

1900 Boothe Cir
Suite 100
Longwood, FL 32750-6751
Phone (407) 774-6800

Other identifiers 1

IdentifierTypeStateIssuer
64003OtherFLBCBS OF FL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051201000537 FL Practitioner - Chiropractic 8820018286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Chiropractic Health Center, LLCGroup PAC ID 3577583939, 2 clinicians

Practice addresses (Care Compare)

7806 Lake Underhill Rd
Orlando, FL 32822-8232
Phone (407) 774-6800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 9040FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Chiropractic Health Center, LLC Chiropractor CurrentSince Sep 29, 2005 Accepting new patients
Check-in Clinic, LLC CurrentSince Mar 21, 2015 Accepting new patients
Check-in Clinic LLC Current Accepting new patients
Florida Chiropractic Health Center Chiropractor Past Accepting new patients

Locations

1900 Boothe Cir
Ste 100
Longwood, FL 32750
Phone (407) 774-6800

7806 Lake Underhill Rd
Ste 104
Orlando, FL 32822
Phone (407) 249-3005

Organizations & group practices 4

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1629122379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 BOOTHE CIR",
            "address_2": "SUITE 100",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506751",
            "telephone_number": "407-774-6800",
            "fax_number": "407-774-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 BOOTHE CIR",
            "address_2": "SUITE 100",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506751",
            "telephone_number": "407-774-6800",
            "fax_number": "407-774-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBENAS",
        "first_name": "ED",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 9040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "64003",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.