NPIMap

Organization Active NPI

Genesis Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Boca Raton, FL
National Provider Identifier
1073982831
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GENESIS COMMUNITY HEALTH INC
Practice address
600 S Dixie Hwy Ste 103
Boca Raton, FL 33432-6034
Phone
(561) 430-3629
Fax
(561) 990-7435
NPI assigned
Sep 22, 2015
Last updated
Nov 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Deanna M Warren
Title
Executive Director/Ceo
Phone
(561) 735-6553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

600 S Dixie Hwy Ste 103
Boca Raton, FL 33432-6034

Mailing address

639 E Ocean Ave Ste 409
Boynton Beach, FL 33435-5017
Phone (561) 806-6835

Other identifiers 2

IdentifierTypeStateIssuer
006608606MedicaidFL
EC290AOtherFLMEDICARE

Other names 1

  • Boca Raton Medical Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110112000690 FL Part B Supplier - Clinic/Group Practice 7012033384 Receives reassigned benefits from 19 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boca Raton, FL; Boynton Beach, FL

Other NPIs on the same Medicare enrollment 1

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

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
10D2103622Genesis Community Health Inc at Boca600 South Dixie Highway Suite 103, Boca Raton, FL 33432Certificate of waiverOct 15, 2027

National Provider Directory

National Provider Directory

Locations

2815 S Seacrest Blvd
Ste Wer
Boynton Beach, FL 33435
Phone (561) 735-6553

564 E Woolbright Rd
Boynton Beach, FL 33435
Phone (561) 735-6553

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1073982831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 E OCEAN AVE STE 409",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334355017",
            "telephone_number": "561-806-6835",
            "fax_number": "561-806-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S DIXIE HWY STE 103",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334326034",
            "telephone_number": "561-430-3629",
            "fax_number": "561-990-7435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS COMMUNITY HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-22",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CEO",
        "authorized_official_telephone_number": "561-735-6553"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006608606",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "EC290A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boca Raton Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.