Elyse Octave

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME152754 Issued in FL

Practice address

2724 N Hiawassee Rd Ste 100
Orlando, FL 32818-3008

Phone

(407) 906-0082

Fax

(407) 604-2606

NPI assigned

Feb 24, 2022

Last updated

Apr 8, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dedicated Senior Medical Center of Florida, LLCGroup PAC ID 4486932100, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1881055366
  Medicare reassignment Care Compare group NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Largo, FL
  • NPI 1659888741
  NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Tampa, FL
  • NPI 1700393881
  NPD
• Dedicated Senior Medical Center of Florida, LLC

  dba Dedicated Senior Medical Center Hiawassee

  • Non-Pharmacy Dispensing Site
  • Orlando, FL
  • NPI 1518593177
  NPD (past)

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1912653361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 N HIAWASSEE RD STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328183008",
            "telephone_number": "407-906-0082",
            "fax_number": "407-604-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 N HIAWASSEE RD STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328183008",
            "telephone_number": "407-906-0082",
            "fax_number": "407-604-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCTAVE",
        "first_name": "ELYSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME152754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Occupational Therapy Professionals LLC
• John Ochieng
• Christine Amanda Ochoa, MD
• Jessica Jannet Ochoa, DOULS
• Julie Oconnor, DPT
• Ocular Prosthetics Lab Inc
• Anita S. Odaiyar
• Odb Health, Inc.
• Theodore Odem Jr.
• Jessica Odermatt

• Family Medicine Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.