Organization Active NPI

Endocrinology of Central Florida PA

  • Endocrinology, Diabetes & Metabolism Physician
  • Deland, FL
National Provider Identifier
1730185307
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
ENDOCRINOLOGY OF CENTRAL FLORIDA PA
Practice address
141 Victoria Commons Blvd
Deland, FL 32724-7700
Phone
(386) 427-4544
Fax
(386) 427-8688
NPI assigned
Jun 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Authorized official

Name
Lee Nathaniel Metchick, MDNPI 1407851801
Title
President
Phone
(386) 427-4544

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X FL Primary

Addresses

Primary practice location

141 Victoria Commons Blvd
Deland, FL 32724-7700

Mailing address

141 Victoria Commons Blvd
Deland, FL 32724-7700
Phone (386) 427-4544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040902001110 FL Part B Supplier - Clinic/Group Practice 5597731380 Receives reassigned benefits from 9 practitioners
Practice locations: Deland, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2170233Endocrinology of Central Florida141 Victoria Commons Blvds, Deland, FL 32724ComplianceDec 15, 2027

National Provider Directory

National Provider Directory

Locations

141 Victoria Commons Blvd
Deland, FL 32724
Phone (386) 427-4544

141 Victoria Commons Blvd
Ste 1003
Deland, FL 32724

929 Williston Park Pt
Lake Mary, FL 32746
Phone (321) 397-1212

237 N Causeway
New Smyrna Beach, FL 32169
Phone (386) 427-4544

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1730185307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 VICTORIA COMMONS BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327247700",
            "telephone_number": "386-427-4544",
            "fax_number": "386-427-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 VICTORIA COMMONS BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327247700",
            "telephone_number": "386-427-4544",
            "fax_number": "386-427-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINOLOGY OF CENTRAL FLORIDA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "METCHICK",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "NATHANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-427-4544",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.