Organization Active NPI

Caremedica Florida LLC

  • Internal Medicine Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1063149193
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAREMEDICA FLORIDA LLC
Practice address
3401 Pga Blvd Ste 310
Palm Beach Gardens, FL 33410-2824
Phone
(561) 776-8890
Fax
(561) 776-2159
NPI assigned
Aug 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Authorized official

Name
Fausto Petruzziello, MDNPI 1316933419
Title
Managing Member
Phone
(561) 776-8890

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3401 Pga Blvd Ste 310
Palm Beach Gardens, FL 33410-2824

Mailing address

3401 Pga Blvd Ste 310
Palm Beach Gardens, FL 33410-2824
Phone (561) 776-8890

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220901000722 FL Part B Supplier - Clinic/Group Practice 2365826849 Receives reassigned benefits from 6 practitioners
Practice locations: Palm Beach Gardens, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1034958Caremedica Florida LLC3401 Pga Blvd Suite 310, Palm Beach Gardens, FL 33410Certificate of waiverDec 16, 2026

National Provider Directory

National Provider Directory

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1063149193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 PGA BLVD STE 310",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102824",
            "telephone_number": "561-776-8890",
            "fax_number": "561-776-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 PGA BLVD STE 310",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102824",
            "telephone_number": "561-776-8890",
            "fax_number": "561-776-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREMEDICA FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "PETRUZZIELLO",
        "authorized_official_first_name": "FAUSTO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "561-776-8890",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.