Individual provider Active NPI

David Thomas Hotwagner, D.O.

  • Emergency Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1962787937
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
U02784 Issued in FL
Practice address
1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521
Phone
(772) 335-4000
NPI assigned
Oct 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X U02784 FL Primary

Addresses

Primary practice location

1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521

Mailing address

1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521
Phone (772) 335-4000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150728004023 FL Practitioner - Emergency Medicine 4688988264 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of FL LLCGroup PAC ID 8426413931, 686 clinicians

Practice addresses (Care Compare)

1800 SE Tiffany Ave
Port Saint Lucie, FL 34952-7521
Phone (772) 335-4000

322 SW Pine Island Rd
Fawcett Memorial
Cape Coral, FL 33991-2057
Phone (941) 249-6858

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U02784FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Jun 1, 2018 Accepting new patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Inphynet Contracting Services LLC Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

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

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 3

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 2

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": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1962787937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 SE TIFFANY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527521",
            "telephone_number": "772-335-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SE TIFFANY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527521",
            "telephone_number": "772-335-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOTWAGNER",
        "first_name": "DAVID",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "U02784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.