Individual provider Active NPI

Edgar B George, M.D.

  • General Practice Physician
  • Orange City, FL
National Provider Identifier
1841542503
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME135094 Issued in FL
Practice address
938 Saxon Blvd Ste D
Orange City, FL 32763-8305
Phone
(352) 259-2159
Fax
(352) 259-5731
NPI assigned
Oct 4, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME135094 FL Primary
General Practice Physician 208D00000X ME135094 ZZ
General Practice Physician 208D00000X 13,114-I PR

Addresses

Primary practice location

938 Saxon Blvd Ste D
Orange City, FL 32763-8305

Mailing address

1580 Santa Barbara Blvd
The Villages, FL 32159-6827
Phone (352) 259-2159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130920000174 PR Practitioner - General Practice 9436307386 Practice locations: Vega Baja, PR
I20141010000812 FL Practitioner - General Practice 9436307386 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13,114-IPRMDGeneral Practice Physician
ME135094ZZMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Associates of Florida LLC CurrentSince Jul 1, 2024 Accepting new patients
Premier Medical Associates All Florida, LLC CurrentSince Jul 1, 2024 Accepting new patients
Premier Medical Associates of Florida Healthcare, PA CurrentSince Jul 1, 2024 Accepting new patients
Premier Medical Associates of Florida LLC CurrentSince Jul 1, 2024 Accepting new patients
Medical Home Alliance LLC Past Accepting new patients
Medical Home Alliance LLC PastSince Aug 15, 2021 Accepting new patients

Locations

938 Saxon Blvd
Ste D
Orange City, FL 32763
Phone (386) 774-7411

1580 Santa Barbara Blvd
The Villages, FL 32159
Phone (352) 494-6882

Organizations & group practices 6

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": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1841542503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SANTA BARBARA BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596827",
            "telephone_number": "352-259-2159",
            "fax_number": "352-259-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 SAXON BLVD STE D",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638305",
            "telephone_number": "352-259-2159",
            "fax_number": "352-259-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "EDGAR",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-04",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME135094",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "ZZ",
            "license": "ME135094",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "13,114-I",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.