NPIMap

Organization Active NPI

Palm Beach Heart Associates PA

  • Interventional Cardiology Physician
  • Atlantis, FL
National Provider Identifier
1124063540
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
PALM BEACH HEART ASSOCIATES PA
Practice address
5503 S Congress Ave
Suite 206
Atlantis, FL 33462-6625
Phone
(561) 433-0591
Fax
(561) 433-0891
NPI assigned
Jun 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Authorized official

Name
Dr. Jay Midwall, MD
Title
President
Phone
(561) 433-0591

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X FL
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X FL Primary

Addresses

Primary practice location

5503 S Congress Ave
Suite 206
Atlantis, FL 33462-6625

Mailing address

5503 S Congress Ave
Suite 206
Atlantis, FL 33462-6625
Phone (561) 433-0591

Other identifiers 3

IdentifierTypeStateIssuer
CL0618OtherFLMCR RR
97633OtherFLBCBS
254158100MedicaidFL

National Provider Directory

National Provider Directory

Locations

5503 S Congress Ave
Ste 206
Lake Worth, FL 33462
Phone (561) 433-0591

301 NW 84th Ave
Ste 200
Plantation, FL 33324
Phone (954) 429-5830

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1124063540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5503 S CONGRESS AVE",
            "address_2": "SUITE 206",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334626625",
            "telephone_number": "561-433-0591",
            "fax_number": "561-433-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5503 S CONGRESS AVE",
            "address_2": "SUITE 206",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334626625",
            "telephone_number": "561-433-0591",
            "fax_number": "561-433-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH HEART ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2015-01-23",
        "status": "A",
        "authorized_official_last_name": "MIDWALL",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-433-0591",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR RR",
            "identifier": "CL0618",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "97633",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254158100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; 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.