Innovative Diabetic Solutions PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INNOVATIVE DIABETIC SOLUTIONS PLLC

Practice address

660 Glades Rd Ste 240
Boca Raton, FL 33431-6466

Phone

(561) 368-2005

Fax

(561) 338-2178

NPI assigned

Jun 5, 2023

Last updated

Jul 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Richard Alexis Conlen, MDNPI 1942260781

Title

Owner

Phone

(561) 368-2005

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

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.

• Richard A Conlen, MD

  • Gynecology Physician
  • Boca Raton, FL
  • NPI 1942260781

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Pauline Marie Cole, NP

  • Adult Health Nurse Practitioner
  • Boca Raton, FL
  • NPI 1376526202
  Medicare reassignment NPD

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1124712054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4317 INTRACOASTAL DRIVE",
            "city": "HIGHLAND BEACH",
            "state": "FL",
            "postal_code": "33487",
            "telephone_number": "561-715-2493",
            "fax_number": "561-338-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 GLADES RD STE 240",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316466",
            "telephone_number": "561-368-2005",
            "fax_number": "561-338-2178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE DIABETIC SOLUTIONS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-05",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "CONLEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALEXIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-368-2005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Innovative GX Florida , Inc
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• Innovative Medical Care, P.a.
• Innovative Supplies, LLC
• Innovative Surgical Assistants LLC

• Family Medicine Physician in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.