NPIMap

Organization Active NPI

Palm Beach Pediatrics, LLC

  • Pediatrics Physician
  • Coconut Creek, FL
National Provider Identifier
1063365716
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PALM BEACH PEDIATRICS, LLC
Practice address
4801 Coconut Creek Pkwy
Coconut Creek, FL 33063-3903
Phone
(561) 509-5009
NPI assigned
Feb 20, 2026
Organization subpart
Yes
Parent organization
PALM BEACH PEDIATRICS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Authorized official

Name
Alexandra Gray
Title
Project Manager
Phone
(561) 509-5009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

4801 Coconut Creek Pkwy
Coconut Creek, FL 33063-3903

Mailing address

2000 Palm Beach Lakes Blvd Ste 901
West Palm Beach, FL 33409-6506
Phone (561) 509-5009

Other names 1

  • Bluebird Kids Health Doing business as

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
10D2342770Palm Beach Pediatrics LLC4801 Coconut Creek Parkway, Coconut Creek, FL 33063Certificate of waiverApr 26, 2028

National Provider Directory

National Provider Directory
Tax ID family
Palm Beach Pediatrics LLC12 organizations share this tax ID, including this one
Part of
Palm Beach Pediatrics LLC

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4801 Coconut Creek Pkwy
Coconut Creek, FL 33063

Practitioners & affiliated clinicians

Practitioners 2

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": "1771545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771545600000",
    "number": "1063365716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PALM BEACH LAKES BLVD STE 901",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096506",
            "telephone_number": "561-509-5009",
            "fax_number": "561-509-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 COCONUT CREEK PKWY",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330633903",
            "telephone_number": "561-509-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH PEDIATRICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALM BEACH PEDIATRICS, LLC",
        "enumeration_date": "2026-02-20",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "PROJECT MANAGER",
        "authorized_official_telephone_number": "561-509-5009"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluebird Kids Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.