NPIMap

Individual provider Active NPI

Eilene K Weibley, MD

  • Family Medicine Physician
  • Englewood, FL
National Provider Identifier
1740509215
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME114030 Issued in FL
Practice address
1885 Englewood Rd
Englewood, FL 34223-1822
Phone
(941) 406-9030
Fax
(941) 406-9031
NPI assigned
May 24, 2010
Last updated
Jan 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 84537 GA
Family Medicine Physician 207Q00000X ME114030 FL Primary

Addresses

Primary practice location

1885 Englewood Rd
Englewood, FL 34223-1822

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other identifiers 1

IdentifierTypeStateIssuer
014022900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150127000350 FL Practitioner - Family Practice 1153645908 Reassigns benefits to 1 organization
I20200316001184 GA Practitioner - Family Practice 1153645908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

3000 S McCall Rd
Englewood, FL 34224-8616
Phone (941) 406-9029

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME114030FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
The Emory Clinic Inc CurrentSince Jul 21, 2020 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
Dekalb Medical Primary Care Group LLC PastSince Jan 1, 2020 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1885 Englewood Rd
Englewood, FL 34223
Phone (941) 406-9030

3000 S McCall Rd
Englewood, FL 34224
Phone (941) 406-9029

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: eilene.weibley.1@4290.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.

Hospital & facility affiliations 7

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": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1740509215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 ENGLEWOOD RD",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342231822",
            "telephone_number": "941-406-9030",
            "fax_number": "941-406-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIBLEY",
        "first_name": "EILENE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-24",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "84537",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME114030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014022900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, FL

Sources for this page

Verify at the official NPI Registry.