Individual provider Active NPI

Eboni Racqia Hamilton, NP

  • Family Medicine Physician
  • Greenacres, FL
National Provider Identifier
1902668684
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11030828 Issued in FL
Practice address
4805 Gladiator Cir
Greenacres, FL 33463-5334
Phone
(561) 797-5254
NPI assigned
Jan 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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 11030828 FL Primary

Addresses

Primary practice location

4805 Gladiator Cir
Greenacres, FL 33463-5334

Mailing address

4805 Gladiator Cir
Greenacres, FL 33463-5334
Phone (561) 797-5254

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240425000083 FL Practitioner - Nurse Practitioner 7315387388 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SLP Health CareGroup PAC ID 1557641768, 4 clinicians
Accountable Care Hospitalist GroupGroup PAC ID 3678733342, 119 clinicians

Practice addresses (Care Compare)

1371 SE Conference Cir
Stuart, FL 34997-7639
Phone (561) 332-2020

5301 S Congress Ave
Atlantis, FL 33462-1149
Phone (561) 965-7300

Hospital & facility affiliations

  • HCA Florida JFK Hospital Hospital, Atlantis, FL, CCN 100080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11030828FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Accountable Care Hospitalist Group CurrentSince Apr 1, 2024 Accepting new patients

Locations

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

1155 S Congress Ave
Ste C
West Palm Beach, FL 33406
Phone 5617661300601

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1902668684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 GLADIATOR CIR",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334635334",
            "telephone_number": "561-797-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 GLADIATOR CIR",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334635334",
            "telephone_number": "561-797-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "EBONI",
        "middle_name": "RACQIA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "11030828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

Verify at the official NPI Registry.