Organization Active NPI

PCC Medical Holdings LLC

  • Internal Medicine Physician
  • Lake Worth, FL
National Provider Identifier
1174167993
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PCC MEDICAL HOLDINGS LLC
Practice address
5055 South Congress Avenue
Suite 303
Lake Worth, FL 33461
Phone
(561) 385-0731
Fax
(561) 629-7302
NPI assigned
Nov 5, 2019
Last updated
Apr 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Authorized official

Name
William Steele, CEO
Title
Ceo
Phone
(561) 385-0731

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary
Clinic/Center 261Q00000X
Health Maintenance Organization 302R00000X

Addresses

Primary practice location

5055 South Congress Avenue
Suite 303
Lake Worth, FL 33461

Mailing address

1732 S Congress Ave Ste 346
Palm Springs, FL 33461-2140
Phone (561) 385-0731

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200924001757 FL Part B Supplier - Clinic/Group Practice 0446679468 Receives reassigned benefits from 66 practitioners
Practice locations: Orlando, FL; Palm Springs, FL; Pembroke Pines, FL; Plantation, FL; Sanford, FL; Stuart, FL; Tamarac, FL; Vero Beach, 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
10D2212041PCC Medical Holdings, LLC5055 South Congress Ave Suite 303, Lake Worth, FL 33461Certificate of waiverFeb 1, 2027

National Provider Directory

National Provider Directory

Locations (25 of 29)

7000 W Palmetto Park Rd
Ste 103
Boca Raton, FL 33433
Phone (561) 347-8122

9878 Clint Moore Rd
Boca Raton, FL 33496

9970 Central Park Blvd N
Ste 205
Boca Raton, FL 33428
Phone (561) 487-1203

3880 Coconut Creek Pkwy
Ste 300
Coconut Creek, FL 33066
Phone (954) 968-2955

8130 Royal Palm Blvd
Coral Springs, FL 33065
Phone (945) 345-4333

8130 Royal Palm Blvd
Ste 205
Coral Springs, FL 33065
Phone (954) 340-1500

1363 S Military Trl
Deerfield Beach, FL 33442
Phone (954) 570-7270

601 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 942-9233

4849 Lake Worth Rd
Fl 1
Greenacres, FL 33463

4849 Lake Worth Rd
Ste 346
Greenacres, FL 33463

5055 S Congress Ave
Lake Worth, FL 33461

4201 N State Road 7
Lauderdale Lakes, FL 33319
Phone (954) 485-1131

100 N State Road 7
Margate, FL 33063
Phone (786) 274-2441

100 N State Road 7
Ste 204
Margate, FL 33063
Phone (954) 971-0330

4100 W New Haven Ave
Melbourne, FL 32904

4100 W New Haven Ave
Ste A
Melbourne, FL 32904
Phone (321) 340-7165

13377 W Dixie Hwy
Fl 1
North Miami, FL 33161
Phone (305) 893-8306

13377 W Dixie Hwy
Ste 1
North Miami, FL 33161

1140 S Semoran Blvd
Ste A
Orlando, FL 32807

1140 S Semoran Blvd
Ste E
Orlando, FL 32807
Phone (407) 384-9165

1880 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (772) 249-0636

309 W 1st St
Sanford, FL 32771
Phone (407) 324-5035

7166 N Nob Hill Rd
Tamarac, FL 33321
Phone (786) 583-5100

1960 Pointe West Dr
Ste 201
Vero Beach, FL 32966
Phone (772) 226-4260

7810 S Dixie Hwy
West Palm Bch, FL 33405
Phone (407) 586-5600

Practitioners & affiliated clinicians

Practitioners 81

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.

View all 81

NPI Registry JSON

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1174167993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 S CONGRESS AVE STE 346",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334612140",
            "telephone_number": "561-385-0731",
            "fax_number": "561-629-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5055 SOUTH CONGRESS AVENUE",
            "address_2": "SUITE 303",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33461",
            "telephone_number": "561-385-0731",
            "fax_number": "561-629-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCC MEDICAL HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-05",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "STEELE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-385-0731",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.