Individual provider Active NPI

Edward Rivers Eastman, M.D.

  • Emergency Medicine Physician
  • Tallahassee, FL
National Provider Identifier
1679547590
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME81379 Issued in FL
Practice address
1300 Miccosukee Rd
Bixler Emergency Center
Tallahassee, FL 32308-5054
Phone
(850) 431-0756
Fax
(850) 431-0779
NPI assigned
Feb 15, 2006
Last updated
Sep 17, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME81379 FL Primary

Addresses

Primary practice location

1300 Miccosukee Rd
Bixler Emergency Center
Tallahassee, FL 32308-5054

Mailing address

1300 Miccosukee Rd
Bixler Emergency Center
Tallahassee, FL 32308-5054
Phone (850) 431-0756

Other identifiers 1

IdentifierTypeStateIssuer
260439600MedicaidFL

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
I20060127000182 FL Practitioner - Emergency Medicine 8921012097 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc CurrentSince Jan 1, 2001 Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
TMH Emergency Physician Group Emergency Medicine PastSince Jul 24, 2022 Accepting new patients

Locations

1260 Metropolitan Blvd
Tallahassee, FL 32312
Phone (850) 422-5413

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

1607 Saint James Ct
Ste 1
Tallahassee, FL 32308
Phone (850) 431-7021

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1679547590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MICCOSUKEE RD",
            "address_2": "BIXLER EMERGENCY CENTER",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085054",
            "telephone_number": "850-431-0756",
            "fax_number": "850-431-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MICCOSUKEE RD",
            "address_2": "BIXLER EMERGENCY CENTER",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085054",
            "telephone_number": "850-431-0756",
            "fax_number": "850-431-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "EDWARD",
        "middle_name": "RIVERS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME81379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260439600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.