Individual provider Active NPI

Deborah R. Nuessly, ARNP

  • Pediatrics Physician
  • Boynton Beach, FL
National Provider Identifier
1073515532
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ARNP 2092962 Issued in FL
Practice address
6080 Boynton Beach Blvd Ste 240
Boynton Beach, FL 33437-3586
Phone
(561) 509-5009
Fax
(561) 738-0556
NPI assigned
Aug 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ARNP 2092962 FL Primary

Addresses

Primary practice location

6080 Boynton Beach Blvd Ste 240
Boynton Beach, FL 33437-3586

Mailing address

1920 Palm Beach Lakes Blvd Ste 201
West Palm Beach, FL 33409-3506
Phone (561) 509-5009

Other identifiers 1

IdentifierTypeStateIssuer
303555700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 2092962FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Beach Pediatrics, LLC Pediatrics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1073515532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 PALM BEACH LAKES BLVD STE 201",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334093506",
            "telephone_number": "561-509-5009",
            "fax_number": "561-738-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 BOYNTON BEACH BLVD STE 240",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373586",
            "telephone_number": "561-509-5009",
            "fax_number": "561-738-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUESSLY",
        "first_name": "DEBORAH",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ARNP 2092962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303555700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.