Coastal Anesthesia, P a

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

COASTAL ANESTHESIA, P A

Practice address

1001 College Blvd W Ste H
Niceville, FL 32578-1049

Phone

(850) 279-4417

Fax

(850) 279-4212

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michael Ederer, DONPI 1588760268

Title

DO/President

Phone

(352) 867-8898

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

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

• Michael P Ederer, DO

  • Pain Medicine (Anesthesiology) Physician
  • Niceville, FL
  • NPI 1588760268

  FL, Pain Medicine

  Medicare reassignment Care Compare group NPD Authorized official
• Katherine Elizabeth Booth, FNP-C

  • Family Nurse Practitioner
  • Destin, FL
  • NPI 1194618686

  FL

  Medicare reassignment Care Compare group NPD
• Julie Devine, NP-C

  • Family Nurse Practitioner
  • Niceville, FL
  • NPI 1679933907

  FL

  Medicare reassignment NPD
• Stacy Nicole Frazier, NP

  • Acute Care Nurse Practitioner
  • Niceville, FL
  • NPI 1073868303

  FL

  Medicare reassignment NPD
• Allison Danielle Christel, FNP-C

  • Family Nurse Practitioner
  • Clovis, NM
  • NPI 1821782988

  FL

  Medicare reassignment NPD
• Enes Mugnolo, AGPCNP

  • Adult Health Nurse Practitioner
  • Lombard, IL
  • NPI 1609396860

  FL

  Medicare reassignment NPD
• Emily Towery, CRNP

  • Gerontology Nurse Practitioner
  • Niceville, FL
  • NPI 1164017612

  FL

  Medicare reassignment

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1932205606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10583",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352020583",
            "telephone_number": "352-867-8898",
            "fax_number": "352-732-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 COLLEGE BLVD W STE H",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781049",
            "telephone_number": "850-279-4417",
            "fax_number": "850-279-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ANESTHESIA, P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "EDERER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DO/PRESIDENT",
        "authorized_official_telephone_number": "352-867-8898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE0932",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "98947",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Willis Cinal, RN
• Landyn Lynn Clark Yudez
• Elizabeth A Clark, M.D.
• Steven Lester Clark, MD
• Christopher Craig Clevenger, PHARMD
• Coastal Orthopedic
• Coastal Vascular and Interventional PLLC
• Coastline Mental Health LLC
• Ashley Coker
• Janice Marie Collier, L.M.H.C.

• Pain Medicine (Anesthesiology) Physician in Niceville, FL
• Providers in Niceville, FL by specialty
• Pain Medicine (Anesthesiology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.