Junior William Pittack, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME89943 Issued in FL

Practice address

4175 W 20TH Ave
Hialeah, FL 33012-5874

Phone

(305) 825-0300

NPI assigned

Jun 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Citrus Health Network Inc

  • Community/Behavioral Health Agency
  • Hialeah, FL
  • NPI 1821138819
  Medicare reassignment NPD
• Citrus Health Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Miami, FL
  • NPI 1396395075
  NPD

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381795200000",
    "number": "1023053931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11320 SW 112TH CIRCLE LN E",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331763861",
            "telephone_number": "305-254-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 W 20TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330125874",
            "telephone_number": "305-825-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTACK",
        "first_name": "JUNIOR",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2013-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME89943",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME89943",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275495900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isabella Kristin Pischner, LCSW
• Yasel Pita Noriega
• Elizabeth Pita Pena, BEHAVIOR TECHNICIAN
• Gemma Pita
• Ivan Pita
• Maria Elena Pizano-Balatovis, MS; RD; LDN; CDE
• Yenifer Pizarro Baez
• PL Roberts Id LLC
• Yindra Pla Gonzalez
• Idania Pla

• Psychiatry Physician in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.