NPIMap

Organization Active NPI

Israel Machin MD PA

  • General Practice Physician
  • Lake Clarke Shores, FL
National Provider Identifier
1104989342
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ISRAEL MACHIN MD PA
Practice address
1511 Forest Hill Blvd
Suite C
Lake Clarke Shores, FL 33406-6077
Phone
(561) 433-3556
Fax
(561) 967-5559
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Israel Machin, MDNPI 1295711349
Title
Owner
Phone
(561) 433-3556

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
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1511 Forest Hill Blvd
Suite C
Lake Clarke Shores, FL 33406-6077

Mailing address

1511 Forest Hill Blvd
Suite C
Lake Clarke Shores, FL 33406-6077
Phone (561) 433-3556

Other identifiers 1

IdentifierTypeStateIssuer
AB648OtherFLMEDICARE GROUP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070416000179 FL Part B Supplier - Clinic/Group Practice 7719082262 Receives reassigned benefits from 8 practitioners
Practice locations: Lake Clarke Shores, 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
10D1104600Israel Machin MD PA1511 Forest Hill Blvd Ste C, Lake Clarke Shores, FL 33406Certificate of waiverSep 3, 2027

National Provider Directory

National Provider Directory

Locations

1511 Forest Hill Blvd
West Palm Beach, FL 33406
Phone (561) 433-3556

1511 Forest Hill Blvd
Ste C
West Palm Beach, FL 33406
Phone (561) 433-3556

Networks

  • HealthSun Health Plans Network

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 11

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": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1104989342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 FOREST HILL BLVD",
            "address_2": "SUITE C",
            "city": "LAKE CLARKE SHORES",
            "state": "FL",
            "postal_code": "334066077",
            "telephone_number": "561-433-3556",
            "fax_number": "561-967-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 FOREST HILL BLVD",
            "address_2": "SUITE C",
            "city": "LAKE CLARKE SHORES",
            "state": "FL",
            "postal_code": "334066077",
            "telephone_number": "561-433-3556",
            "fax_number": "561-967-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISRAEL MACHIN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "MACHIN",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-433-3556",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "AB648",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Clarke Shores, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.