Individual provider Active NPI

Stephen Patrick Griffith, MD

  • General Practice Physician
  • New Smyrna Beach, FL
National Provider Identifier
1902883200
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME93277 Issued in FL
Practice address
4150 S Atlantic Ave Apt 111a
New Smyrna Beach, FL 32169-3761
Phone
(321) 514-1774
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Preventive Medicine) Physician 2083B0002X ME93277 FL
Legal Medicine (M.D./D.O.) Physician 209800000X ME93277 FL
General Practice Physician 208D00000X ME93277 FL Primary

Addresses

Primary practice location

4150 S Atlantic Ave Apt 111a
New Smyrna Beach, FL 32169-3761

Mailing address

PO Box 541162
Merritt Island, FL 32954-1162
Phone (321) 514-1774

Other practice location 1

870 York St
San Francisco, CA 94110-2843
Phone (855) 527-1850

Other identifiers 1

IdentifierTypeStateIssuer
2437858MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MO, AK, GU4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20050811000731 FL Practitioner - Emergency Medicine 0749173110
I20121211000565 MO Practitioner - Emergency Medicine 0749173110 Reassigns benefits to 1 organization
I20171031003156 AK Practitioner - Emergency Medicine 0749173110 Reassigns benefits to 1 organization
I20200806000349 GU Practitioner - Emergency Medicine 0749173110 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME93277FLMDLegal Medicine (M.D./D.O.) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Healthcare Development Incorporated CurrentSince Jul 6, 2020 Accepting new patients
Nes Washington, Inc. Emergency Medicine CurrentSince Sep 2, 2017 Accepting new patients
Guidewell Emergency Medicine Doctors, LLC CurrentSince Apr 6, 2025 Accepting new patients
Capital Emergency Physicians, PC Emergency Medicine CurrentSince Jul 13, 2015 Accepting new patients
Samaritan Emergency Corp Emergency Medicine Past Accepting new patients
Nes Ohio Inc Emergency Medicine Past Accepting new patients

Locations

3100 Tongass Ave
Ketchikan, AK 99901
Phone (907) 225-4104

113 N Orlando Ave
Winter Park, FL 32789
Phone (407) 801-8400

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1902883200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 541162",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329541162",
            "telephone_number": "321-514-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 S ATLANTIC AVE APT 111A",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321693761",
            "telephone_number": "321-514-1774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "870 York St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941102843",
            "country_code": "US",
            "telephone_number": "855-527-1850",
            "fax_number": "650-360-0447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "STEPHEN",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "FL",
            "license": "ME93277",
            "primary": false
        },
        {
            "code": "209800000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "FL",
            "license": "ME93277",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME93277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2437858",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.