Organization Active NPI

Coral Ridge Gastroenterology Associates LLC

  • Gastroenterology Physician
  • Ft Lauderdale, FL
National Provider Identifier
1265628424
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CORAL RIDGE GASTROENTEROLOGY ASSOCIATES LLC
Practice address
2021 E Commercial Blvd
Suite 202
Ft Lauderdale, FL 33308-3763
Phone
(954) 202-7850
Fax
(954) 202-7781
NPI assigned
Sep 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Authorized official

Name
V. Alin Botoman, M.D.
Title
Facg/Facp
Phone
(954) 202-7850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

2021 E Commercial Blvd
Suite 202
Ft Lauderdale, FL 33308-3763

Mailing address

2021 E Commercial Blvd
Suite 202
Ft Lauderdale, FL 33308-3763
Phone (954) 202-7850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080709000060 FL Part B Supplier - Clinic/Group Practice 1658443650 Receives reassigned benefits from 14 practitioners
Practice locations: Pompano Beach, FL; Fort Lauderdale, FL; Oakland Park, FL; Boynton Beach, FL

National Provider Directory

National Provider Directory

Locations

4181 NW 1st Ave
Ste 11
Boca Raton, FL 33431

4181 NW 1st Ave
Ste 101
Boca Raton, FL 33431

1325 S Congress Ave
Boynton Beach, FL 33426
Phone (561) 734-4545

4701 N Federal Hwy
Ste 10
Fort Lauderdale, FL 33308

2021 E Commercial Blvd
Ste 202
Ft Lauderdale, FL 33308
Phone (954) 202-7850

4800 NE 20th Ter
Ste 105
Ft Lauderdale, FL 33308
Phone (954) 489-0600

4800 NE 20th Ter
Ft Lauderdale, FL 33308
Phone (954) 351-7770

5301 N Dixie Hwy
Ste 202
Oakland Park, FL 33334
Phone (954) 202-7850

550 SW 3rd St
Ste 206
Pompano Beach, FL 33060
Phone (305) 755-2320

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1265628424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 E COMMERCIAL BLVD",
            "address_2": "SUITE 202",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083763",
            "telephone_number": "954-202-7850",
            "fax_number": "954-202-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 E COMMERCIAL BLVD",
            "address_2": "SUITE 202",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083763",
            "telephone_number": "954-202-7850",
            "fax_number": "954-202-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAL RIDGE GASTROENTEROLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "BOTOMAN",
        "authorized_official_first_name": "V.",
        "authorized_official_middle_name": "ALIN",
        "authorized_official_title_or_position": "FACG/FACP",
        "authorized_official_telephone_number": "954-202-7850",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; 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.