Active NPI
Theron Ebel, MD
- Pulmonary Disease Physician
- Tampa, FL
National Provider Identifier
1801904347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- ME20283
- Practice address
- 3000 Medical Park Dr
Suite 190
Tampa, FL 33613-4680 - Phone
- (813) 977-7794
- Fax
- (813) 355-5067
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | ME20283 | FL | Primary |
Addresses
Primary practice location
3000 Medical Park Dr
Suite 190
Tampa, FL 33613-4680
Mailing address
38135 Market Square
Zephyrhills, FL 33542
Phone (813) 528-4975
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 260189300 | Medicaid | FL | |
| P00273074 | Other | FL | RR MEDICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pulmtpa@flmed.directbygreenway.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME20283 | FL | MD | Pulmonary Disease Physician |
| 20283 | FL | MD | Physical Therapy Assistant |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629849600000",
"number": "1801904347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38135 MARKET SQUARE",
"city": "ZEPHYRHILLS",
"state": "FL",
"postal_code": "33542",
"telephone_number": "813-528-4975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 MEDICAL PARK DR",
"address_2": "SUITE 190",
"city": "TAMPA",
"state": "FL",
"postal_code": "336134680",
"telephone_number": "813-977-7794",
"fax_number": "813-355-5067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBEL",
"first_name": "THERON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2021-08-25",
"certification_date": "2021-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "FL",
"license": "ME20283",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "260189300",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00273074",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pulmtpa@flmed.directbygreenway.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "3000 Medical Park Dr",
"address_2": "Suite 190",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336134680",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.