NPIMap

Organization Active NPI

Ortho Florida, LLC

Doing business as Podiatry Associates of Palm Beach Gardens

  • Podiatrist
  • Jupiter, FL
National Provider Identifier
1174289045
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
ORTHO FLORIDA, LLC
Doing business as
Podiatry Associates of Palm Beach Gardens
Practice address
4601 Military TRL Ste 202
Jupiter, FL 33458-4835
Phone
(561) 624-4800
NPI assigned
Nov 15, 2021
Last updated
Nov 15, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ORTHO FLORIDA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Authorized official

Name
Dane Trask
Title
Of Ceo
Phone
(813) 747-1128

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X Primary

Addresses

Primary practice location

4601 Military TRL Ste 202
Jupiter, FL 33458-4835

Mailing address

433 Plaza Real Ste 275
Boca Raton, FL 33432-3999

Other names 1

  • Podiatry Associates of Palm Beach Gardens Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220225002160 FL DME Supplier - Physician - General PracticeDME Supplier - Sports Medicine 3274616453 Practice locations: Jupiter, FL

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Ortho Florida LLC48 organizations share this tax ID, including this one
Part of
Ortho Florida LLC

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1174289045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 PLAZA REAL STE 275",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334323999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 MILITARY TRL STE 202",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584835",
            "telephone_number": "561-624-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO FLORIDA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHO FLORIDA, LLC",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "TRASK",
        "authorized_official_first_name": "DANE",
        "authorized_official_title_or_position": "OF CEO",
        "authorized_official_telephone_number": "813-747-1128"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Podiatry Associates of Palm Beach Gardens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.