Organization Active NPI

Neurological Disorders Clinic PA

  • Specialist
  • Boca Raton, FL
National Provider Identifier
1043375611
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
74877 Issued in FL
Legal business name
NEUROLOGICAL DISORDERS CLINIC PA
Practice address
880 NW 13TH St
Suite 3-B
Boca Raton, FL 33486-2342
Phone
(561) 394-0005
Fax
(561) 393-0048
NPI assigned
Dec 26, 2006
Last updated
Aug 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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

Authorized official

Name
Dr. Fernano Norona, M.D.
Title
Director
Phone
(561) 394-0005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 74877 FL Primary

Addresses

Primary practice location

880 NW 13TH St
Suite 3-B
Boca Raton, FL 33486-2342

Mailing address

880 NW 13TH St
Suite 3-B
Boca Raton, FL 33486-2342
Phone (561) 394-0005

Other identifiers 9

IdentifierTypeStateIssuer
49479OtherFLBLUE SHIELD FL PROVIDER
49479ZOtherDCMEDICARE INDIVIDUAL
WM988OtherNEEMPIRE BC BS
2338601OtherFLAETNA HMO
032627OtherFLNHP
2338601OtherFLAETNA
74877OtherFLFL LICENSE NUMBER
1026677OtherFLCARE PLU
5890751OtherFLAETNA NON HMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110412000578 FL Part B Supplier - Clinic/Group Practice 8224212451 Receives reassigned benefits from 1 practitioner
Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory

Locations

880 NW 13th St
Ste 3B
Boca Raton, FL 33486
Phone (561) 392-6226

951 NW 13th St
Ste 2B
Boca Raton, FL 33486
Phone (561) 379-1613

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282003200000",
    "number": "1043375611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 NW 13TH ST",
            "address_2": "SUITE 3-B",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862342",
            "telephone_number": "561-394-0005",
            "fax_number": "561-393-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 NW 13TH ST",
            "address_2": "SUITE 3-B",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862342",
            "telephone_number": "561-394-0005",
            "fax_number": "561-393-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGICAL DISORDERS CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2010-08-17",
        "status": "A",
        "authorized_official_last_name": "NORONA",
        "authorized_official_first_name": "FERNANO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "561-394-0005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "74877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD FL PROVIDER",
            "identifier": "49479",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL",
            "identifier": "49479Z",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC BS",
            "identifier": "WM988",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2338601",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "032627",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2338601",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE NUMBER",
            "identifier": "74877",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE PLU",
            "identifier": "1026677",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON HMO",
            "identifier": "5890751",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; 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.