Individual provider Active NPI

Beth Joy Kozak, D.C.

  • Chiropractor
  • Palm Beach Gardens, FL
National Provider Identifier
1265733604
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7712 Issued in FL
Practice address
4043 Hood Road
Palm Beach Gardens, FL 33410-2171
Phone
(561) 622-2466
Fax
(561) 622-2606
NPI assigned
Nov 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7712 FL Primary
Nutrition Chiropractor 111NN1001X CH7712 FL

Addresses

Primary practice location

4043 Hood Road
Palm Beach Gardens, FL 33410-2171

Mailing address

4043 Hood Road
Palm Beach Gardens, FL 33410-2171
Phone (561) 622-2466

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110331000658 FL Practitioner - Chiropractic 7618159484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5540 Pga Blvd
Suite 100
Palm Beach Gardens, FL 33418-3987
Phone (561) 596-2714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH7712FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ahava-5772, LLC Chiropractor CurrentSince Aug 8, 2016 Accepting new patients

Locations

5540 Pga Blvd
Ste 100
Palm Beach Gardens, FL 33418
Phone (561) 596-2714

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1265733604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4043 HOOD ROAD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102171",
            "telephone_number": "561-622-2466",
            "fax_number": "561-622-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4043 HOOD ROAD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102171",
            "telephone_number": "561-622-2466",
            "fax_number": "561-622-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "BETH",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-16",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7712",
            "primary": true
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "FL",
            "license": "CH7712",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.