Mark Allen Eberbach, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0048142 Issued in FL

Practice address

14012 US Highway 19
Hudson, FL 34667-1165

Phone

(727) 868-4490

Fax

(727) 869-7085

NPI assigned

Jun 16, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: meberbach296642@direct.tgh.org

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.

• Mark a Eberbach MD PA

  • Ambulatory Surgical Clinic/Center
  • Hudson, FL
  • NPI 1124274493
  NPD (past) Authorized official
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237161600000",
    "number": "1750386744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14012 US HIGHWAY 19",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346671165",
            "telephone_number": "727-868-4490",
            "fax_number": "727-869-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14012 US HIGHWAY 19",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346671165",
            "telephone_number": "727-868-4490",
            "fax_number": "727-869-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERBACH",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2009-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0048142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "07923",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Durbin
• Amanda Nicole Durrett, FNP
• Olivia Alyssa Duval, APRN
• Dwic of Tampa Bay, Inc
• East-West Chiropractic & Rehabilitation of Hudson
• Economy Dentures of Hudson LLC
• Lauren E Edwards, PT
• Jermaine Ekobena, DO
• Alina A El Chami Martinez, OTR/L
• Mark Elias

• Specialist in Hudson, FL
• Providers in Hudson, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.