Individual provider Active NPI

Jeffrey Friedman, D.O.

  • Family Medicine Physician
  • Deland, FL
National Provider Identifier
1821089699
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS0005813 Issued in FL
Practice address
937 N Spring Garden Ave
Deland, FL 32720-2560
Phone
(386) 736-1948
Fax
(386) 736-2784
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS0005813 FL Primary

Addresses

Primary practice location

937 N Spring Garden Ave
Deland, FL 32720-2560

Mailing address

154 Standish Dr
Ormond Beach, FL 32176-4751
Phone (386) 299-2546

Other practice location 1

401 Venture Dr
Suite A
South Daytona, FL 32119-3478
Phone (386) 761-8888

Other identifiers 1

IdentifierTypeStateIssuer
371133100MedicaidFL

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
I20101108000280 FL Practitioner - Family Practice 9335334101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Health Care Plan IncGroup PAC ID 9436201233, 97 clinicians

Practice addresses (Care Compare)

937 N Spring Garden Rd
Deland, FL 32720-2560
Phone (386) 736-1948

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS0005813FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Care Plan, Inc CurrentSince May 15, 2023 Accepting new patients
Florida Health Care Plan, Inc CurrentSince May 15, 2023 Accepting new patients
Ormond Medical Arts Family Practice LLC Family Medicine CurrentSince Jan 1, 2021 Accepting new patients

Locations

937 N Spring Garden Ave
Deland, FL 32720
Phone (386) 736-1948

77 W Granada Blvd
Ormond Beach, FL 32174
Phone (386) 677-0453

740 Dunlawton Ave
Ste 200
Port Orange, FL 32127
Phone (386) 763-1000

401 Venture Dr
Ste A
South Daytona, FL 32119
Phone (386) 761-8888

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1579/brand/8/csg/141/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1821089699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 STANDISH DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321764751",
            "telephone_number": "386-299-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 N SPRING GARDEN AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202560",
            "telephone_number": "386-736-1948",
            "fax_number": "386-736-2784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Venture Dr",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "South Daytona",
            "state": "FL",
            "postal_code": "321193478",
            "country_code": "US",
            "telephone_number": "386-761-8888",
            "fax_number": "386-760-8799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0005813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371133100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.