Organization Active NPI

Delvis a Celdran MD PA

  • Neurology Physician
  • Port Saint Lucie, FL
National Provider Identifier
1871688879
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
DELVIS A CELDRAN MD PA
Practice address
543 NW Lake Whitney PL
Unit 105
Port Saint Lucie, FL 34986-1604
Phone
(772) 335-3255
Fax
(772) 335-3256
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Authorized official

Name
Delvis A Celdran, MDNPI 1780649541
Title
MD
Phone
(772) 335-3255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

543 NW Lake Whitney PL
Unit 105
Port Saint Lucie, FL 34986-1604

Mailing address

PO Box 882229
Port Saint Lucie, FL 34988-2229
Phone (772) 335-3255

Other identifiers 2

IdentifierTypeStateIssuer
275863600MedicaidFL
DG1486OtherFLRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070731000398 FL Part B Supplier - Clinic/Group Practice 6406957786 Receives reassigned benefits from 1 practitioner
Practice locations: Port Saint Lucie, FL

National Provider Directory

National Provider Directory

Locations

543 NW Lake Whitney Pl
Port Saint Lucie, FL 34986
Phone (772) 335-3255

543 NW Lake Whitney Pl
Ste 105
Port St Lucie, FL 34986
Phone (772) 335-3255

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1871688879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 882229",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349882229",
            "telephone_number": "772-335-3255",
            "fax_number": "772-335-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 NW LAKE WHITNEY PL",
            "address_2": "UNIT 105",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861604",
            "telephone_number": "772-335-3255",
            "fax_number": "772-335-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELVIS A CELDRAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "CELDRAN",
        "authorized_official_first_name": "DELVIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "772-335-3255",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275863600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG1486",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.