Individual provider Active NPI

Great Patoombal, ARNP-BC

  • Family Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1104362904
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9280339 Issued in FL
Practice address
852 Quartz Ter
West Palm Beach, FL 33413-1200
Phone
(561) 797-7306
NPI assigned
Jan 17, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9280339 FL Primary
Family Health Clinical Nurse Specialist 364SF0001X 9280339 FL

Addresses

Primary practice location

852 Quartz Ter
West Palm Beach, FL 33413-1200

Mailing address

852 Quartz Ter
West Palm Beach, FL 33413-1200
Phone (561) 797-7306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170824000585 FL Practitioner - Nurse Practitioner 1052683117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501
Phone (561) 420-8555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9280339FLMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Nov 4, 2021 Accepting new patients
MD Now Medical Centers Inc CurrentSince Nov 4, 2021 Accepting new patients
Health & Wellness Center LLC CurrentSince May 16, 2017 Accepting new patients
Shamsad Begum MD PA PastSince May 16, 2017 Accepting new patients

Locations

1838 Rye Rd
#107
Bradenton, FL 34212
Phone (941) 462-2004

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

1770 NE Miami Gardens Dr
North Miami Beach, FL 33179
Phone (305) 949-4141

1195 N Military Trl
Ste 2A
West Palm Beach, FL 33409
Phone (561) 683-4100

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1104362904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "852 QUARTZ TER",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334131200",
            "telephone_number": "561-797-7306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 QUARTZ TER",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334131200",
            "telephone_number": "561-797-7306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATOOMBAL",
        "first_name": "GREAT",
        "name_prefix": "Mr.",
        "credential": "ARNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-17",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9280339",
            "primary": true
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "FL",
            "license": "9280339",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.