JAY W EDELBERG (NPI# 1174618110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174618110 |
| Entity Type | Individual |
| Full Name | JAY W EDELBERG |
| Credential | MD |
| Practice Address |
400 Health Park Blvd St Augustine FL 32086-5784 |
| Mailing Address |
Po Box 863639 Orlando FL 32886-3639 |
| Practice Telephone | 9048264700 |
| Practice Fax Number | 9043460113 |
| Mailing Telephone | 9048270507 |
| Mailing Fax Number | 9043460113 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | ME0026894 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 057200400 | 05 | |
| FL | RAILROAD MEDICARE | P00138989 | 01 |
| FL | BCBS | 15358 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245327329 | Jay Edelberg | Internal Medicine | 520 E 70th St # Starr-4, New York, NY 10021-9800 | 2006-10-09 |
| Street Address |
400 HEALTH PARK BLVD |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32086-5784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801881818 | Emergency Physicians of St. Johns County | Emergency Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2005-09-15 |
| 1245846468 | Nicole Marie Zisman | Internal Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2020-09-22 |
| 1700499522 | Yolanda Campbell | Family Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2020-08-31 |
| 1952912826 | Megan Burke | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5790 | 2020-08-13 |
| 1639709173 | Keith Latasiewicz | Nurse Anesthetist, Certified Registered | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2020-01-23 |
| 1508416991 | Ashley Jarriel Gucwa | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2019-09-17 |
| 1831741925 | Jessica Anne Lindamood | Dietitian, Registered | 400 Health Park Blvd, St Augustine, FL 32086-5790 | 2019-07-10 |
| 1649787326 | Spencer Jonathan Garrison | Nurse Anesthetist, Certified Registered | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2018-01-04 |
| 1750804662 | Gabrielle Du Sablon | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2017-07-23 |
| 1124540588 | Jessica Marie Johnson | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2017-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225670037 | Ramonica Flagler | Nurse Practitioner | 3574 Us-1 South, St. Augustine, FL 32086 | 2019-10-14 |
| 1518522648 | Marissa Marie Lynch | Physician Assistant | 100 Whetstone Pl Ste 102, St Augustine, FL 32086 | 2019-05-03 |
| 1346706991 | Castillo Transportation | Non-emergency Medical Transport (VAN) | 295 North Hidden Tree Dr, Saint Augustine, FL 32086 | 2019-02-19 |
| 1790255842 | Michelle Moore | In Home Supportive Care | 135 Jenkins St. Suite 105b #265, St.augustine, FL 32086 | 2018-12-03 |
| 1649740200 | Paul James Lietz IIi | Physical Therapist | One Orthopedic Place, Saint Augustine, FL 32086 | 2018-11-27 |
| 1548764707 | Oceanside Endodontics Od St. Augustine | Dentist | 2510 U.S. 1 South, Suite B, St. Augustine, FL 32086 | 2018-03-22 |
| 1023538329 | Joseph R Edwards | Physical Therapist | 968 Espinado Avenue, St Augustine, FL 32086 | 2017-06-27 |
| 1235662032 | Jennifer L Csenge | Dentist | 4327 Us Highway 1 S, St Augustine, FL 32086 | 2017-04-07 |
| 1336683663 | Lisa Brice | Social Worker | 248 Southpark Circle East, Saint Augustine, FL 32086 | 2016-12-06 |
| 1558813303 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 65 Whitehall Drive, Saint Augustine, FL 32086 | 2016-10-27 |
| Find all providers in zip 32086 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033282199 | Billy Franklin Gardner II | Emergency Medicine | 120 Health Park Blvd Ste 1, St Augustine, FL 32086-5798 | 2006-11-16 |
| 1831142330 | Kristine Ann Rynn | Emergency Medicine | 16 Saint Johns Medical Pk Dr, St Augustine, FL 32086-5299 | 2006-05-18 |
| 1245207950 | Marc J Farraye | Emergency Medicine | 218 Sophia Ter, St Augustine, FL 32095-6812 | 2006-03-01 |
| 1801881818 | Emergency Physicians of St. Johns County | Emergency Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2005-09-15 |
| 1750626479 | Emergency Physicians Inc | Emergency Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2012-12-06 |
| 1215142559 | Natalie Dawn Lambie | Emergency Medicine | 400 Health Park Blvd, Emergency Department, St Augustine, FL 32086-5784 | 2007-05-11 |
| 1134264641 | Cobblestone Emergency Physicians | Emergency Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2007-02-21 |
| 1255426193 | Mark L Grobelny | Emergency Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2006-10-04 |
| 1013002864 | Teresa M Mazur | Emergency Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2006-10-04 |
| 1760438006 | Kathleen M Hughes | Emergency Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2006-05-26 |
| Find all providers in ST AUGUSTINE | ||||
| City | ST AUGUSTINE |
| Zip Code | 32086 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.