Individual provider Active NPI

Michael D Paul, M.D

  • Specialist
  • Port St Lucie, FL
National Provider Identifier
1669403200
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0070321 Issued in FL
Practice address
1701 SE Hillmoor Dr
Port St Lucie, FL 34952-7552
Phone
(772) 398-9998
Fax
(772) 398-9986
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0070321 FL Primary

Addresses

Primary practice location

1701 SE Hillmoor Dr
Port St Lucie, FL 34952-7552

Mailing address

705 NE Stokes Ter
Jensen Beach, FL 34957-3735
Phone (772) 334-2694

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
I20110317000558 FL Practitioner - Neurosurgery 2961495270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Temple University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1701 SE Hillmoor Dr
Port Saint Lucie, FL 34952-7552
Phone (772) 398-9998

Hospital & facility affiliations

  • Vitalcaring Group Home health agency, West Palm Beach, FL, CCN 108331
  • St Lucie Medical Center Hospital, Port Saint Lucie, FL, CCN 100260

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion92
Laminectomy or laminotomy (partial removal of spine bones)21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0070321FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Macmillan Paul and Burkarth PA Specialist CurrentSince Nov 1, 1997 Accepting new patients

Locations

1701 SE Hillmoor Dr
#8
Port Saint Lucie, FL 34952
Phone (772) 398-9998

1701 SE Hillmoor Dr
Ste 8
Port St Lucie, FL 34952
Phone (561) 335-4000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1669403200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 NE STOKES TER",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349573735",
            "telephone_number": "772-334-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SE HILLMOOR DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527552",
            "telephone_number": "772-398-9998",
            "fax_number": "772-398-9986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0070321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.