Advanced Pediatric Pulmonology, PLLC

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

Legal business name

ADVANCED PEDIATRIC PULMONOLOGY, PLLC

Practice address

1971 SW 172ND Ave Ste 3128
Miramar, FL 33029-5592

Phone

(954) 299-5272

Fax

(855) 583-3365

NPI assigned

Jun 9, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Marie Myrtha Gregoire-Bottex, MD

Title

Managing Member

Phone

(914) 462-7411

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• n/a Former legal business name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marie-Myrtha Gregoire-Bottex, MD

  • Pediatric Pulmonology Physician
  • Miramar, FL
  • NPI 1437340676

  FL, Pediatric Pulmonology

  Medicare reassignment NPD

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1053095265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 BISCAYNE BLVD APT 7102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331375302",
            "telephone_number": "914-462-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1971 SW 172ND AVE STE 3128",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295592",
            "telephone_number": "954-299-5272",
            "fax_number": "855-583-3365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16161 NW 57h Ave",
            "address_purpose": "LOCATION",
            "city": "Miami Gardens",
            "state": "FL",
            "postal_code": "330143301",
            "country_code": "US",
            "telephone_number": "954-299-5272",
            "fax_number": "855-583-3365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16161 NW 57h Ave",
            "address_purpose": "LOCATION",
            "city": "Miami Lakes",
            "state": "FL",
            "postal_code": "330143301",
            "country_code": "US",
            "telephone_number": "954-299-5272",
            "fax_number": "855-583-3365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2701 Biscayne Blvd Apt 7102",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331375302",
            "country_code": "US",
            "telephone_number": "914-462-7411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED PEDIATRIC PULMONOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-09",
        "last_updated": "2024-08-05",
        "certification_date": "2024-01-06",
        "status": "A",
        "authorized_official_last_name": "GREGOIRE-BOTTEX",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "MYRTHA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "914-462-7411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102074500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "10D2296465",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00118945800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE PROVIDER",
            "identifier": "2HXM4",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11995072",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "1J6FX",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "adva.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "adva.eclinicaldirectplus.com",
            "address_1": "2701 Biscayne Blvd Apt 7102",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331375302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "p2p",
            "affiliation": "N",
            "endpointDescription": "information exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CVS and PDF",
            "address_1": "2701 Biscayne Blvd Apt 7102",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331375302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "n/a",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• All providers in Miramar, FL
• Pediatric Pulmonology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.