Individual provider Active NPI

Dylan Elder, DO

  • Anesthesiology Physician
  • Warrensville Heights, OH
National Provider Identifier
1730641507
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
19937 Issued in FL
Practice address
South Pointe Hospital
20000 Harvard Rd
Warrensville Heights, OH 44122
Phone
(216) 491-6000
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 58.030632 OH
Anesthesiology Physician 207L00000X 19937 FL Primary

Addresses

Primary practice location

South Pointe Hospital
20000 Harvard Rd
Warrensville Heights, OH 44122

Mailing address

South Pointe Hospital
20000 Harvard Rd
Warrensville Heights, OH 44122

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
I20231108003456 FL Practitioner - Anesthesiology 2961745542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19937FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Physician Solutions of North Florida, LLC Anesthesiology CurrentSince Oct 4, 2023 Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC Anesthesiology CurrentSince Oct 4, 2023 Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC Anesthesiology Current Accepting new patients

Locations

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

325 Cypress Pkwy
Poinciana, FL 34759
Phone (407) 530-2000

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1730641507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SOUTH POINTE HOSPITAL",
            "address_2": "20000 HARVARD RD",
            "city": "WARRENSVILLE HEIGHTS",
            "state": "OH",
            "postal_code": "44122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SOUTH POINTE HOSPITAL",
            "address_2": "20000 HARVARD RD",
            "city": "WARRENSVILLE HEIGHTS",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-491-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "DYLAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "58.030632",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "19937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrensville Heights, OH

Sources for this page

Verify at the official NPI Registry.