Florida Atlantic University

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

FLORIDA ATLANTIC UNIVERSITY

Doing business as

Florida Atlantic University Alzheimer's Prevention Clinic

Practice address

777 Glades Rd
Office Building 1
Boca Raton, FL 33431-6496

Phone

(561) 566-5328

Fax

(561) 299-4220

NPI assigned

Feb 21, 2014

Last updated

Apr 23, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Louisa Pontiroli-Kelly

Title

Authorized Official

Phone

(561) 297-2897

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Florida Atlantic University Alzheimer's Prevention Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Florida Atlantic University

  dba FAU Community Health Center

  • Federally Qualified Health Center (FQHC)
  • West Palm Beach, FL
  • NPI 1093026619

  O20040511001511

  Same enrollment
• Florida Atlantic University

  dba Memory and Wellness Center

  • Gerontology Nurse Practitioner
  • Boca Raton, FL
  • NPI 1164591954

  O20040511001511

  Same enrollment
• Florida Atlantic University

  dba Communication Sciences & Disorders

  • Speech-Language Pathologist
  • Boca Raton, FL
  • NPI 1245873975

  O20040511001511

  Same enrollment
• Florida Atlantic University

  dba College of Medicine Clinic

  • Internal Medicine Physician
  • Boca Raton, FL
  • NPI 1396211421

  O20040511001511

  Same enrollment

Locations

Practitioners 3

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.

• Hollie Hristov, FNP

  • Family Nurse Practitioner
  • Boca Raton, FL
  • NPI 1972951309
  NPD
• Richard S Isaacson, M.D.

  • Neurology Physician
  • Boca Raton, FL
  • NPI 1124056932
  NPD
• Leonard Kyle Berkowitz, DO

  • Family Medicine Physician
  • Boca Raton, FL
  • NPI 1588659353
  NPD (past)

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

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682208000000",
    "number": "1053736405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 GLADES RD",
            "address_2": "OFFICE BUILDING 1",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316496",
            "telephone_number": "561-566-5328",
            "fax_number": "561-299-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 GLADES RD",
            "address_2": "OFFICE BUILDING 1",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316496",
            "telephone_number": "561-566-5328",
            "fax_number": "561-299-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA ATLANTIC UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-21",
        "last_updated": "2023-04-23",
        "certification_date": "2023-04-23",
        "status": "A",
        "authorized_official_last_name": "PONTIROLI-KELLY",
        "authorized_official_first_name": "LOUISA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "561-297-2897"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALZHEIMER'S PREVENTION CLINIC",
            "identifier": "0000000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Atlantic University Alzheimer's Prevention Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adelle M Flores-Yoshitomi, LMHC
• Ashley N Flores, LCSW-C, CAC-AD
• Victor Flores
• Laura Florez
• Florida Atlantic Orthopedics LLC
• Florida Atlantic University (FAU Sports Medicine)
• Florida Atlantic University (Memory and Wellness Center)
• Florida Atlantic University (Communication Sciences & Disorders)
• Florida Atlantic University (Student Health Center Clinic)
• Florida Atlantic University (College of Medicine Clinic)

• Alzheimer Center (Dementia Center) in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Alzheimer Center (Dementia Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2023; 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.