Palm Beach General Surgery LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PALM BEACH GENERAL SURGERY LLC

Practice address

12983 Southern Blvd
Loxahatchee, FL 33470-9207

Phone

(561) 439-0961

Fax

(561) 439-0963

NPI assigned

Sep 28, 2007

Last updated

Jun 4, 2009By 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

Gary Duncan

Title

VP

Phone

(561) 439-0961

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Palm Beach General Surgery LLC

  • Surgery Physician
  • Atlantis, FL
  • NPI 1710040266

  O20070409000637

  Same enrollment
• Palm Beach General Surgery LLC

  dba JFK Medical Specialists

  • Gastroenterology Physician
  • Atlantis, FL
  • NPI 1801015177

  O20070409000637

  Same enrollment

Locations

Networks

• HealthSun Health Plans Network

Practitioners 176

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.

• Carlos Alejo, M.D.

  • Surgery Physician
  • Okeechobee, FL
  • NPI 1144479817
  Medicare reassignment Care Compare group NPD
• Barbara J Allen, ARNP

  • Nurse Practitioner
  • Sebastian, FL
  • NPI 1619094943
  Medicare reassignment Care Compare group NPD
• Oswald Junior Alphonse, PA-C

  • Physician Assistant
  • Stuart, FL
  • NPI 1750576617
  Medicare reassignment Care Compare group NPD
• Kayla Nicole Amato

  • Physician Assistant
  • Port Saint Lucie, FL
  • NPI 1942063508
  Medicare reassignment Care Compare group NPD
• Brittany Lynn Bagwell, PA-C

  • Physician Assistant
  • Okeechobee, FL
  • NPI 1760267769
  Medicare reassignment Care Compare group NPD
• Heidi Bahna, MD

  • Colon & Rectal Surgery Physician
  • Atlantis, FL
  • NPI 1215176474
  Medicare reassignment Care Compare group NPD
• Heather Michelle Baldriche, APRN

  • Family Nurse Practitioner
  • Lake Worth, FL
  • NPI 1720646003
  Medicare reassignment Care Compare group NPD
• Melinda Marie Blom, PA-C

  • Physician Assistant
  • Loxahatchee, FL
  • NPI 1255529442
  Medicare reassignment Care Compare group NPD
• Justin Boccardo, M.D.

  • Vascular Surgery Physician
  • Fort Pierce, FL
  • NPI 1598887275
  Medicare reassignment Care Compare group NPD
• Mariliz D. Britton, ARNP

  • Family Nurse Practitioner
  • Loxahatchee, FL
  • NPI 1053840090
  Medicare reassignment Care Compare group NPD
• Jon Robert Brown, DO

  • Surgery Physician
  • Port St Lucie, FL
  • NPI 1598887010
  Medicare reassignment Care Compare group NPD
• Rafael Miguel Bustamante, M.D.

  • Vascular Surgery Physician
  • Fort Lauderdale, FL
  • NPI 1164743837
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244073600000",
    "number": "1235326760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12983 SOUTHERN BLVD",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709207",
            "telephone_number": "561-439-0961",
            "fax_number": "561-439-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12983 SOUTHERN BLVD",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709207",
            "telephone_number": "561-439-0961",
            "fax_number": "561-439-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH GENERAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2009-06-04",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "561-439-0961"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00686505",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fernando Enrique Ottino, M.D.
• P Konda MD PA
• Palm Beach Anesthesia Partners, Inc.
• Palm Beach County Graduate Medical Education/Palms West Hospital
• Palm Beach Elder Care LLC
• Palm Beach Nephrology Partners LLC
• Palm Beach Nephrology,P.a.
• Palm Beach Pediatric Lung and Asthma Center, LLC (Palm Beach Pediatric Lung and Asthma Center)
• Palm Beach Surgical Associates, LLC
• Palm Beach Surgical First Assist Inc

• Surgery Physician in Loxahatchee, FL
• Providers in Loxahatchee, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.