Jecebu Josol Ceballos, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME96424 Issued in FL

Practice address

61 Memorial Medical Pkwy
Suite 2806
Palm Coast, FL 32164-5981

Phone

(386) 586-1920

Fax

(386) 586-1921

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

No

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: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jceballos57903@adventhealth.direct-ci.com

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.

• Adventhealth Primary Care Network Inc

  • Family Medicine Physician
  • Altamonte Springs, FL
  • NPI 1093493637

  Family Medicine, FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1740394352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 MEMORIAL MEDICAL PKWY",
            "address_2": "SUITE 2806",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645981",
            "telephone_number": "386-586-1920",
            "fax_number": "386-586-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MEMORIAL MEDICAL PKWY",
            "address_2": "SUITE 2806",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645981",
            "telephone_number": "386-586-1920",
            "fax_number": "386-586-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEBALLOS",
        "first_name": "JECEBU",
        "middle_name": "JOSOL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME96424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaslin Tapia Carvalho
• John J Cascone, MD
• Richard V. Cashio Jr., M.D.
• Paul Cavalluzzo, D.D.S.
• Jessica Lynn Cavinta, LMHC
• Centered in Compassion Counseling LLC
• Cerrato Associates Incorporation
• Bonnie Marie Chalker, O.D.
• Desiree Montanari Challice I, P.T., DPT
• Chamion N. Olivier MD PA

• All providers in Palm Coast, FL
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.