NPIMap

Individual provider Active NPI

Edison Tenezaca Quizhpi, MD

  • Internal Medicine Physician
  • Clermont, FL
National Provider Identifier
1891445094
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME175203 Issued in FL
Practice address
1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone
(352) 536-8840
Fax
(352) 536-8841
NPI assigned
Mar 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME175203 FL Primary

Addresses

Primary practice location

1900 Don Wickham Dr
Clermont, FL 34711-1979

Mailing address

1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone (352) 536-8840

Other practice location 1

1978 Industrial Blvd
Chabert Medical Center
Houma, LA 70363
Phone (985) 873-2710

Other identifiers 1

IdentifierTypeStateIssuer
128075700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250828005476 FL Practitioner - Internal Medicine 9234506866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone (352) 536-8840

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Aug 1, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2025 Accepting new patients

Locations

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1891445094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-536-8840",
            "fax_number": "352-536-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-536-8840",
            "fax_number": "352-536-8841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1978 Industrial Blvd",
            "address_2": "Chabert Medical Center",
            "address_purpose": "LOCATION",
            "city": "Houma",
            "state": "LA",
            "postal_code": "70363",
            "country_code": "US",
            "telephone_number": "985-873-2710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TENEZACA QUIZHPI",
        "first_name": "EDISON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME175203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128075700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.