Individual provider Active NPI

Jon Campitelli

  • Family Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1245647551
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS14056 Issued in FL
Practice address
8200 Okeechobee Blvd
West Palm Beach, FL 33411-2099
Phone
(561) 964-1111
NPI assigned
Jul 18, 2014
Last updated
Sep 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS14056 FL Primary

Addresses

Primary practice location

8200 Okeechobee Blvd
West Palm Beach, FL 33411-2099

Mailing address

8200 Okeechobee Blvd
West Palm Beach, FL 33411-2099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170221001292 FL Practitioner - Family Practice 7416231337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8200 Okeechobee Blvd
West Palm Beach, FL 33411-2099
Phone (561) 964-1111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS14056FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Palm Beach Physicians & Urgent Care, Inc. CurrentSince Sep 7, 2016 Accepting new patients
Central Palm Beach Physicians & Urgent Care Inc CurrentSince Sep 7, 2016 Accepting new patients
Ronald S Smith OD PA Past Accepting new patients

Locations

4623 Forest Hill Blvd
Ste 101
West Palm Beach, FL 33415
Phone (561) 966-7194

8200 Okeechobee Blvd
West Palm Beach, FL 33411
Phone (561) 798-2425

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1245647551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 OKEECHOBEE BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334112099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 OKEECHOBEE BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334112099",
            "telephone_number": "561-964-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPITELLI",
        "first_name": "JON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-18",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS14056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.