NPIMap

Individual provider Active NPI

Walter Offenhartz, MD

  • Internal Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1124159355
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 97962 Issued in FL
Practice address
140 SW Chamber CT
Suite 100
Port St Lucie, FL 34986-3496
Phone
(772) 878-0303
Fax
(772) 878-0353
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 97962 FL Primary

Addresses

Primary practice location

140 SW Chamber CT
Suite 100
Port St Lucie, FL 34986-3496

Mailing address

140 SW Chamber CT
Suite 100
Port St Lucie, FL 34986-3496
Phone (772) 873-0303

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 97962FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lucie Medical Specialists LLC Internal Medicine Past Accepting new patients
St Lucie Medical Center Walk-in Clinic LLC Past Accepting new patients

Organizations & group practices 2

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1124159355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SW CHAMBER CT",
            "address_2": "SUITE 100",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863496",
            "telephone_number": "772-873-0303",
            "fax_number": "772-873-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SW CHAMBER CT",
            "address_2": "SUITE 100",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863496",
            "telephone_number": "772-878-0303",
            "fax_number": "772-878-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFFENHARTZ",
        "first_name": "WALTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 97962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.