Michael D. Eastridge, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY0003431 Issued in FL

Practice address

275 96TH Ave N
Suite 3
Saint Petersburg, FL 33702-2504

Phone

(727) 579-0080

Fax

(727) 578-2542

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720129539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 96TH AVE N",
            "address_2": "SUITE 3",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337022504",
            "telephone_number": "727-579-0080",
            "fax_number": "727-578-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 96TH AVE N",
            "address_2": "SUITE 3",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337022504",
            "telephone_number": "727-579-0080",
            "fax_number": "727-578-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTRIDGE",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY0003431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Maria Eardley
• Jordan E Earle, LCSW
• Leigh C Earle, M.A., CCC
• Kerry Brent Earlywine, PHARM.D.
• Carleah G East, PHD
• Eastwinds of Florida Inc.
• Easy Access FL LLC
• Easy Care Living Companion& Home Health Agency. Inc
• Eaton Orthopaedics LLC
• Katulle Koli Eaton, M.D.

• Clinical Neuropsychologist in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.