East Coast Bariatrics, Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

EAST COAST BARIATRICS, INC.

Practice address

201 N Clyde Morris Blvd
Suite 100 a
Daytona Beach, FL 32114-2724

Phone

(386) 676-7130

Fax

(386) 676-7125

NPI assigned

May 25, 2010

Last updated

Dec 30, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wendy A. Myers, M.D.NPI 1407816283

Title

Chief Executive Officer

Phone

(386) 676-7100

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Harry H Black, MD

  • Integrative Medicine Physician
  • Ormond Beach, FL
  • NPI 1982691077

  Surgery

  Medicare reassignment NPD
• Juliana Demello, APRN

  • Family Nurse Practitioner
  • Palm Coast, FL
  • NPI 1568930980
  Medicare reassignment NPD
• Yaischa C Dukes

  • Nurse Practitioner
  • Tampa, FL
  • NPI 1194277459
  Medicare reassignment NPD
• Jennifer Eve Rosenberg-Ocadiz, ARNP

  • Family Nurse Practitioner
  • Lake Mary, FL
  • NPI 1477008050
  Medicare reassignment NPD
• Joel L Sebastien, MD

  • Surgery Physician
  • Daytona Beach, FL
  • NPI 1639166739
  Medicare reassignment NPD
• Wendy Myers, MD

  • Legal Medicine
  • Holly Hill, FL
  • NPI 1407816283
  NPD (past) Authorized official
• Rachel Love Quarberg, M.D.

  • Family Medicine Physician
  • Orange City, FL
  • NPI 1528387743
  NPD (past)

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388361600000",
    "number": "1932428372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9671",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321209671",
            "telephone_number": "386-676-7130",
            "fax_number": "386-676-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N CLYDE MORRIS BLVD",
            "address_2": "SUITE 100 A",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142724",
            "telephone_number": "386-676-7130",
            "fax_number": "386-676-7125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COAST BARIATRICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-25",
        "last_updated": "2013-12-30",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "386-676-7100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001C8",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1932428372",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "943055",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DR2599",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.