Active NPI
Edward Supinski, MD
- Internal Medicine Physician
- Port Orange, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME 80671
- Practice address
- 3691 Clyde Morris Blvd
Port Orange, FL 32129-2317 - Phone
- (386) 675-4411
- Fax
- (866) 542-5859
- NPI assigned
- Mar 14, 2006
- Last updated
- Feb 17, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME 80671 | FL | Primary |
Addresses
Primary practice location
3691 Clyde Morris Blvd
Port Orange, FL 32129-2317
Mailing address
6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 259199500 | Medicaid | FL | |
| 35630 | Other | FL | BCBS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | edward.supinski.1@29601.direct.athenahealth.com |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Temple University School of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3691 S Clyde Morris Blvd
Port Orange, FL 32129-2317
Phone (386) 675-4411
5238 -16 Norwood Ave
Jacksonville, FL 32208-5005
Phone (904) 861-1222
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 80671 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inpatient Consultants of Florida, Inc | Internal Medicine | Current | Accepting new patients |
| Inpatient Consultants of Florida Inc | Internal Medicine | Current | Accepting new patients |
| Conviva Medical Center Management LLC | Internal Medicine | Current | Accepting new patients |
| Img Medical Group de PA | Internal Medicine | Past | Accepting new patients |
| Metcare of Florida, Inc | Internal Medicine | Past | Accepting new patients |
Locations
5238 Norwood Ave
#16
Jacksonville, FL 32208
Phone (904) 265-2050
6101 Blue Lagoon Dr
Ste 400
Miami, FL 33126
Phone (305) 500-2114
6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836
2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151
350 7th St N
Naples, FL 34102
Phone (239) 436-5000
3641 Clyde Morris Blvd
Ste 100
Port Orange, FL 32129
Phone (305) 500-2114
3691 Clyde Morris Blvd
Port Orange, FL 32129
Phone (386) 675-4410
1430 SW Saint Lucie West Blvd
Ste 101
Port St Lucie, FL 34986
Phone (772) 877-3591
6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411
3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222
Interoperability endpoints
- edward.supinski.1@29601.direct.athenahealth.com
Organizations & group practices 5
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.
-
dba Conviva Care Center
- Internal Medicine Physician
- Miami, FL
- NPI 1649324278
-
- Internal Medicine Physician
- Orange Park, FL
- NPI 1396795597
-
- Hospitalist Physician
- Tampa, FL
- NPI 1457511164
Internal Medicine
-
- Sports Medicine (Family Medicine) Physician
- Boynton Beach, FL
- NPI 1720708589
Internal Medicine
-
dba Conviva Care Center
- Internal Medicine Physician
- Hialeah, FL
- NPI 1902893225
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba AdventHealth Daytona Beach
- General Acute Care Hospital
- Daytona Beach, FL
- NPI 1063426823
-
dba AdventHealth Daytona Beach
- Clinical Medical Laboratory
- Daytona Beach, FL
- NPI 1104696178
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771286400000",
"number": "1700854833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6101 BLUE LAGOON DR STE 200",
"city": "MIAMI",
"state": "FL",
"postal_code": "331263168",
"fax_number": "386-676-7125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3691 CLYDE MORRIS BLVD",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321292317",
"telephone_number": "386-675-4411",
"fax_number": "866-542-5859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUPINSKI",
"first_name": "EDWARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-14",
"last_updated": "2026-02-17",
"certification_date": "2026-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME 80671",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "259199500",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "35630",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "edward.supinski.1@29601.direct.athenahealth.com",
"affiliation": "N",
"address_1": "3691 Clyde Morris Blvd",
"city": "Port Orange",
"state": "FL",
"country_code": "US",
"postal_code": "321292317",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Port Orange, FL
- Success Speech Therapy, LLC
- Sue Levy PSYD LCSW PA
- Summerville at Port Orange, Inc. (Brookdale Yorktowne)
- Suncoast Vein & Vascular Clinic PLC
- Sunshine Physicians Inc
- Surgery Center of Volusia, LLC (Surgery Center of Volusia)
- Courtney Sutherland
- Meaghan E Sutter, AP, LMT
- Eyad Swaity, MD
- Jonathan Dalton Sweat, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.