NPIMap

Organization Active NPI

Primus Medical Group LLC

  • Family Medicine Physician
  • Boynton Beach, FL
National Provider Identifier
1245107580
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIMUS MEDICAL GROUP LLC
Practice address
10817 S Jog Rd Ste 230
Boynton Beach, FL 33437-0912
Phone
(561) 634-8888
NPI assigned
Oct 21, 2025
Last updated
Oct 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

Name
Richard Lucibella
Title
Managing Member
Phone
(561) 634-8888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

10817 S Jog Rd Ste 230
Boynton Beach, FL 33437-0912

Mailing address

2240 W Woolbright Rd Ste 317
Boynton Beach, FL 33426-6364

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260420001644 FL Part B Supplier - Clinic/Group Practice 4486120110 Receives reassigned benefits from 17 practitioners
Practice locations: Palm Springs, FL; Greenacres, FL; Boynton Beach, FL; Boca Raton, FL

National Provider Directory

National Provider Directory

Locations

2240 W Woolbright Rd
Ste 317
Boynton Beach, FL 33426
Phone (561) 200-0047

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1761004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1245107580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 W WOOLBRIGHT RD STE 317",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334266364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10817 S JOG RD STE 230",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334370912",
            "telephone_number": "561-634-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMUS MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "LUCIBELLA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "561-634-8888"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; 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.