Organization Active NPI

Northwell Health Medical, Inc

  • Internal Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1205604113
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTHWELL HEALTH MEDICAL, INC
Practice address
222 Lakeview Ave Ste 900&950
West Palm Beach, FL 33401-6145
Phone
(561) 475-5700
Fax
(877) 550-1796
NPI assigned
Dec 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Authorized official

Name
Dr. Nicole Basile, MD
Title
Administrator
Phone
(561) 475-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

222 Lakeview Ave Ste 900&950
West Palm Beach, FL 33401-6145

Mailing address

222 Lakeview Ave Ste 900&950
West Palm Beach, FL 33401-6145
Phone (561) 475-5700

Other practice location 1

1500 N Dixie Hwy Ste 304
West Palm Beach, FL 33401-2717
Phone (561) 475-5700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250227000357 FL Part B Supplier - Clinic/Group Practice 1052831591 Receives reassigned benefits from 4 practitioners
Practice locations: West Palm Beach, FL; Jupiter, 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
10D2312114Northwell Health Medical Inc222 Lakeview Ave Suite 900/950, West Palm Beach, FL 33401Certificate of waiverOct 3, 2026

National Provider Directory

National Provider Directory

Locations

222 Lakeview Ave
Ste 900950
West Palm Beach, FL 33401
Phone (561) 475-5700

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773878400000",
    "number": "1205604113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 LAKEVIEW AVE STE 900&950",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334016145",
            "telephone_number": "561-475-5700",
            "fax_number": "561-828-5998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 LAKEVIEW AVE STE 900&950",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334016145",
            "telephone_number": "561-475-5700",
            "fax_number": "877-550-1796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 N Dixie Hwy Ste 304",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334012717",
            "country_code": "US",
            "telephone_number": "561-475-5700",
            "fax_number": "877-550-1796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHWELL HEALTH MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-20",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A",
        "authorized_official_last_name": "BASILE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "561-475-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; 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.