Individual provider Active NPI

Ira Bruce Brassloff, MD

  • Internal Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1013939834
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0073457 Issued in FL
Practice address
1552 Palm Beach Lakes Blvd
West Palm Beach, FL 33401-2302
Phone
(561) 659-7411
Fax
(561) 659-7423
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0073457 FL Primary

Addresses

Primary practice location

1552 Palm Beach Lakes Blvd
West Palm Beach, FL 33401-2302

Mailing address

1552 Palm Beach Lakes Blvd
West Palm Beach, FL 33401-2302
Phone (561) 659-7411

Other identifiers 1

IdentifierTypeStateIssuer
254974300MedicaidFL

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
I20100326000306 FL Practitioner - Internal Medicine 1456315993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Flagler Medical Associates PAGroup PAC ID 5799772596, 9 clinicians

Practice addresses (Care Compare)

1552 Palm Beach Lakes Blvd
West Palm Beach, FL 33401-2302
Phone (561) 659-7411

Hospital & facility affiliations

  • Community Home Health Services Home health agency, Lake Worth, FL, CCN 107325
  • Trilogy Home Healthcare Home health agency, West Palm Beach, FL, CCN 107714
  • Good Samaritan Medical Center Hospital, West Palm Beach, FL, CCN 100287
  • Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0073457FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flagler Medical Associates PA Internal Medicine CurrentSince May 15, 2010 Accepting new patients

Locations

1552 Palm Beach Lakes Blvd
West Palm Beach, FL 33401
Phone (561) 659-7411

300 Executive Center Dr
West Palm Beach, FL 33401
Phone (561) 471-5566

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIFIBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/GIFIBA/Endpoint/GIFIBA

Organizations & group practices 1

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 4

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1013939834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1552 PALM BEACH LAKES BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012302",
            "telephone_number": "561-659-7411",
            "fax_number": "561-659-7423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 PALM BEACH LAKES BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012302",
            "telephone_number": "561-659-7411",
            "fax_number": "561-659-7423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASSLOFF",
        "first_name": "IRA",
        "middle_name": "BRUCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0073457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254974300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.