Individual provider Active NPI

Arthur Ebere Nwaubani, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Leesburg, FL
National Provider Identifier
1679748107
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
ME106875 Issued in FL
Practice address
312 S Lake St
Leesburg, FL 34748-5920
Phone
(352) 431-3600
Fax
(352) 460-0853
NPI assigned
Apr 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X ME106875 FL Primary
Clinical Neurophysiology Physician 2084N0600X ME106875 FL

Addresses

Primary practice location

312 S Lake St
Leesburg, FL 34748-5920

Mailing address

PO Box 490950
Leesburg, FL 34749-0950
Phone (352) 431-3600

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
I20140627001417 FL Practitioner - Neurology 5799900148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

312 S Lake St
Leesburg, FL 34748-5920
Phone (352) 431-3600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME106875FLMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uced PLLC Neurology With Special Qualifications in Child Neurology CurrentSince May 1, 2014 Accepting new patients

Locations

312 S Lake St
Leesburg, FL 34748
Phone (352) 314-9300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AEBHCA/Endpoint/AEBHCA

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.

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1679748107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490950",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347490950",
            "telephone_number": "352-431-3600",
            "fax_number": "352-460-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S LAKE ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485920",
            "telephone_number": "352-431-3600",
            "fax_number": "352-460-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAUBANI",
        "first_name": "ARTHUR",
        "middle_name": "EBERE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-25",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "FL",
            "license": "ME106875",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "FL",
            "license": "ME106875",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.